Abstract
Cellular DNA content (ploidy) and proliferation activity (e.g., S-phase fraction) measured by flow cytometry have been usually related to the biologic aggressiveness of various neoplasms. In this study, these parameters were analyzed in paraffin-embedded tumor specimens from 43 cases of resected non-small-cell lung cancer (NSCLC). Additionally, the correlation of them with both prognosis and a variety of clinic-pathological features were investigated. The stage and the appearance of both local recurrence and metastasis were related to overall survival of patients. Twenty-two tumors (51.2%) had a diploid DNA distribution, while 21 were aneuploid (48.8%). The mean of aneuploidy was 1.6% ± 0.3%. A correlation was found between ploidy and survival as well as with the appearance of local recurrence and/or metastasis. The mean values of S-phase fraction of diploid and aneuploid tumors were 16.7 ± 11.3% and 32.9 ± 12.1%, respectively, which were significantly different (P=0.0022). Similar results were obtained analyzing the proliferation index (sum of cells in S and G2/M phases of cell cycle) (P=0.0040). However, no correlation between these parameters and both overall survival of patients and clinicopathological features was observed. Our results could suggest the potential use of ploidy analysis as a useful complement of TNM stage in NSCLC.
Highlights
Lung cancer is one of the most frequently occurring neoplasms and is the leading cause of death by cancer worldwide [1]
Several tumor markers, clinic-pathological indicators, and genetic alterations have been assessed in non-small-cell lung cancer (NSCLC) for identifying patients with a poor prognosis and for a better guide of treatment strategy [4]
The aim of this study was to evaluate the relationship between DNA ploidy, S-phase fraction (SPF), proliferation index, and some clinicopathological parameters as well as their impact in the overall survival of NSCLC patients
Summary
Lung cancer is one of the most frequently occurring neoplasms and is the leading cause of death by cancer worldwide [1]. There are two main variants of the disease, non-smallcell lung cancer (NSCLC) and small cell lung cancer (SCLC). NSCLC represents more than 80% of all lung carcinomas [2]. Patients with NSCLC have a poor prognosis because most of them present with advanced or metastatic diseases at the time of diagnosis. In patients with NSCLC, some genetic and regulatory aberrations have been considered responsible for the tumor survival advantage. Several tumor markers, clinic-pathological indicators, and genetic alterations have been assessed in NSCLC for identifying patients with a poor prognosis and for a better guide of treatment strategy [4]
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