Lung cancer prediction: Phase transitions and cell ratio factors

Abstract

e22170 Background: Search of precise prognostic factors for non-small lung cancer (LC) patients (LCP) was realized. Methods: In trial (1985–2008) the data of consecutive 490 LCP after complete resections R0 (age=56.7±8 years; m=439, f=51; tumor diameter: D=4.5±2.1 cm; pneumonectomies=206, lobectomies=284, combined procedures with resection of pericardium, atrium, aorta, VCS, carina, diaphragm, ribs=130; squamous=308, adenocarcinoma=147, large cell=35; T1=143, T2=217, T3=107, T4=23; N0=282, N1=115, N2=93; G1=114, G2=140, G3=236; early LC: LC till 2 cm in D with N0=58, invasive LC=432) was reviewed. Variables selected for 5-year survival (5YS) study were input levels of blood cell subpopulations, TNMG, D. Neural networks computing, Cox regression, clustering, structural equation modeling, Monte Carlo and bootstrap simulation were used to determine any significant regularity. Results: For total of 490 LCP overall life span (LS) was 1824±1304 days (median=1879) and real 5YS reached 62%, 10 years - 50.3%, 20 years - 45.3%. 304 LCP (LS=2597.3±1037 days) lived more than 5 years without LC progressing. 186 LCP (LS=559.8±383.1 days) died because of LC during first 5 years after surgery. 5YS of early LCP was significantly superior (100%) compared with invasive LCP (56.9%) (P=0.000 by log-rank test). 5YS of LCP with N0 was significantly better (78.4%) compared with LCP with N1–2 (39.9%) (P=0.000). Cox modeling displayed that 5YS significantly depended on: phase transition (PT) in terms of synergetics “early-invasive LC”, PT N0-N12, histology, G1–3, cell ratio factors: ratio between the total populations of leucocytes, lymphocytes, neutrophils and LC cells (P=0.000–0.044). Neural networks computing, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT “early-invasive LC”, (rank=1), PT N0-N12 (2), histology (3), G1–3 (4), T1–4 (5), ratio of lymphocytes/LC cells (6), healthy cells/LC cells (7), erythrocytes/LC cells (8), thrombocytes/LC cells (9), eosinophils/LC cells (10), neutrophils/LC cells (11). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; urea under ROC curve=1.0). Conclusions: 5YS of LCP after radical procedures depended on: 1) PT “early-invasive LC”; 2) PT N0-N12; 3) cell ratio factors; 4) LC characteristics. No significant financial relationships to disclose.