Prognostic significance of apoptotic index in completely resected non-small-cell lung cancer

Citation
F. Tanaka et al., Prognostic significance of apoptotic index in completely resected non-small-cell lung cancer, J CL ONCOL, 17(9), 1999, pp. 2728-2736
Citations number
43
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Oncology,"Onconogenesis & Cancer Research
Journal title
JOURNAL OF CLINICAL ONCOLOGY
ISSN journal
0732-183X → ACNP
Volume
17
Issue
9
Year of publication
1999
Pages
2728 - 2736
Database
ISI
SICI code
0732-183X(199909)17:9<2728:PSOAII>2.0.ZU;2-V
Abstract
Purpose: To evaluate the significance of apoptotic index [Al) as a prognost ic factor after surgery for nonsmall-cell lung cancer (NSCLC). Patients and Methods: A total of 236 patients who underwent surgery for pre viously untreated pathologic stage I to IIIa NSCLC between 1985 and 1990 we re reviewed. Al was defined as the number of apoptotic cells, detected by t erminal deaxynucleotidyl transferase-mediated deoxyuridine triphosphate-bio tin nick end-labeling, per 1,000 tumor cells. Proliferative index (PI) and aberrant p53 expression were also evaluated immunohistochemically. Results: The 5-year survival rate for the lowest-Al group (Al < 5.0) was 74 .7%; those for the lower-Al group (5.0 less than or equal to Al < 11.0) and the higher-Al group(11.0 less than or equal to Al < 25.0) were 51.6% and 5 7.8%, respectively These survival rates were significantly lower than that of the lowest-Al group (P = .021 and P = .043, respectively). The highest-A l group (25.0 less than or equal to Al), however, showed the most favorable prognosis, with a 5-year survival rate of 83.2%. Multivariate analysis con firmed that a moderate Al (5.0 less than or equal to Al < 11.0 or 11.0 less than or equal to Al < 25.0) was a significant factor to predict poor progn osis. The pls for the lowest-, the lower-, the higher-, and the highest-Al groups were 32.3%, 48.0%, 54.3%, and 50.7%, respectively. The lowest-Al gro up showed a favorable prognosis because of its low PI, whereas the lower- a nd the higher-Al groups had a poor prognosis caused by increased cancer-cel l proliferation. The highest-Al group showed the most favorable prognosis b ecause apoptotic cell death overcame cell proliferation. No significant cor relation was observed between Al and aberrant p53 expression. Conclusion: Al proved to be an independent prognostic factor in NSCLC. a 19 99 by American Society of Clinical Oncology.