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A Journal on Cardiac, Vascular and Thoracic Surgery

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The Journal of Cardiovascular Surgery 2001 August;42(4):555-60

language: English

Flow cytometric analysis of DNA content and proliferation and immunohistochemical staining of Ki-67 in non-small cell lung cancer

Hofmann H.-S., Knolle J. *, Bahn H. *, Klapperstück T. **, Lautenschläger C. ***, Neef H.

From the Department of Cardio-Thoracic Surgery,
*Institute of Pathology,
**Department of Dermatology,
***Institute of Medical Statistics
Martin-Luther-University Halle-Wittenberg, Halle, Germany


Background. The aim of our ­study was to exam­ine the sig­nif­i­cance of ­tumour DNA-con­tent and pro­life­ra­tion in ­lung can­cer.
Methods. The DNA con­tent and S-­phase frac­tion (SPF) was deter­mined by ­flow cytom­e­try in 125 resect­ed ­tumours of ­patients ­with non-­small ­cell ­lung can­cer. In 40 cas­es we com­pared the SPF ­with immu­no­his­to­chem­i­cal stain­ing of the Ki-67 pro­tein ­using MIB-1 anti­body.
Results. DNA aneu­ploidy was detect­ed in 84.8% (106/125). Cell ­cycle anal­y­sis for the deter­mi­na­tion of pro­life­ra­tion activ­ity was ­only pos­sible in 69 (55.2%) cas­es. An SPF of 0-8% as a ­sign of low pro­life­ra­tion was ­found in 27 spec­i­mens. In ­advanced ­tumours at ­stage III and IV the pro­por­tion of ­tumours ­with SPF 9-16% was sig­nif­i­cant­ly (p<0.05) ­increased as com­pared to ­tumours at ­stage I and II. There was a sig­nif­i­cant cor­re­la­tion (p=0.012, ­ascent: 0.045) ­between SPF and MIB-1. Patients ­with aneu­ploid ­tumours had a rel­a­tive ­risk of 1.4 to die ear­li­er than ­patients ­with dip­loid ­tumours. Patients ­with SPF of 9-16% in the ­tumour tend­ed to ­decreased sur­vi­val (5-­year sur­vi­val ­rate: 29%) in cor­re­la­tion to ­patients ­with a per­cent­age of SPF 0-8% (5-­year sur­vi­val ­rate: 38%, p=0.5). These dif­fer­enc­es ­were sig­nif­i­cant (p=0.048) in ­patients ­with aden­o­car­cin­o­mas ­only. In the mul­ti­var­i­ate COX-regres­sion mod­el age (p=0.03) and ­stage (p=0.0001) ­were sig­nif­i­cant prog­nos­tic fac­tors, ­ploidy ­state (p=0.33) was of no prog­nos­tic sig­nif­i­cance.
Conclusions. Flow cytom­e­try ­seems to be a use­ful meth­od for under­stand­ing the clin­i­cal beha­vi­our of ­lung can­cer. Especially the SPF in aden­o­car­cin­o­mas may be ­used as a prog­nos­tic indi­ca­tor.

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