P68.13 Lung Cancer Prognosis and Cell Ratio Factors

Abstract

We examined cell ratio factors (CRF) significantly affecting non-small cell lung cancer (LC) patients (LCP) survival. CRF - ratio between cancer cells (CC) and blood cells subpopulations. We analyzed data of 768 consecutive LCP (T1-4N0-2M0) (age=57.6±8.3 years; tumor size=4.1±2.4 cm) radically operated (R0) and monitored in 1985-2021 (m=660, f=108; upper lobectomies=277, lower lobectomies=177, middle lobectomies=18, bilobectomies=42, pneumonectomies=254, mediastinal lymph node dissection=768; combined procedures with resection of trachea, carina, atrium, aorta, VCS, vena azygos, pericardium, liver, diaphragm, ribs, esophagus=193; only surgery-S=618, adjuvant chemoimmunoradiotherapy-AT=150: CAV/gemzar + cisplatin + thymalin/taktivin + radiotherapy 45-50Gy; T1=320, T2=255, T3=133, T4=60; N0=516, N1=131, N2=121, M0=768; G1=194, G2=243, G3=331; squamous=417, adenocarcinoma=301, large cell=50; right LC=412, left LC=356; central=290; peripheral=478. Variables selected for prognosis study were input levels of 45 blood parameters, sex, age, TNMG, cell type, tumor size. Survival curves were estimated by the Kaplan-Meier method. Differences in curves between groups of LCP were evaluated using a log-rank test. Multivariate Cox modeling, discriminant analysis, clustering, SEPATH, Monte Carlo, bootstrap and neural networks computing were used to determine any significant dependence. Overall life span (LS) was 2244.9±1750.3 days and cumulative 5-year survival (5YS) reached 72.9%, 10 years – 64.3%, 20 years – 43.1%. 502 LCP lived more than 5 years (LS=3128.7±1536.8 days), 145 LCP – more than 10 years (LS=5068.5±1513.2 days).199 LCP died because of LC (LS=562.7±374.5 days). Cox modeling displayed that LCP survival significantly depended on CRF: leucocytes/CC, segmented neutrophils/CC, lymphocytes/CC, healthy cells/CC (P=0.000-0.016). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and healthy cells/CC (rank=1), segmented neutrophils/CC (rank=2), erythrocytes/CC (rank=3), thrombocytes/CC (4), leucocytes/CC (5), lymphocytes/CC (6), eosinophils/CC (7), monocytes/CC (8), stick neutrophils/CC (9). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0). Lung cancer patients survival after radical procedures significantly depended on cell ratio factors.