Two cell kinetic parameters, the 3H-thymidine labeling index (TLI) and the mitotic index (MI), were studied in vitro on fragments of squamous cell carcinoma tissue of the larynx. They were evaluated to identify those elements able to characterize the growth of these solid tumors. The values of these parameters were analyzed as a function of the clinical stage and the involvement of the regional lymph nodes. Results showed a statistically significant increase in the TLI from stage ll to T3. No statistically significant differences in the TLI values were observed between the patients with positive and negative lymph nodes. HEAD & NECK 1991;13:344-348 As yet, no reliable histomorphologic or biochemical parameters have been determined which, based on tumor growth and its correlation to clinical data, can be used safely in therapeutic planning to improve prognosis.The proliferative rate of tumors is subject to a marked variability due to intrinsic characteristics, such as cell cycle time, growth fraction, cell loss, and degree of differentiation. Tumor growth is further influenced by the microenvironment and by the immunologic response of the patient. Therefore, the evolution of a malignant neoplasia can show much variability depending on factors linked to the disease, to the patient, and to treatment and its effectiveness in controlling tumor growth.Even with these limitations, evaluation of the number of cells that are duplicating DNA at the time of surgical removal gives a direct indication of the growth capacity of the tumor. Several studies, performed on a large number of patients and with an adequate follow-up, demonstrate that the 3H-thymidine labeling index (TLI) value at the time of surgery is a valuable prognostic instrument for neoplasias of the breast, ovaries, head, and neck. '-6 The aim of the present study was to analyze the correlations between cell kinetic parameters and clinical stage, involvement of regional lymph nodes before treatment, rate of relapse, metastasis, and survival when long-term follow-up data are available. MATERIALS AND METHODSThirty one consecutive patients (27 men, 4 women), between 47 and 72 years of age (median 62 years), were examined in this study. All had tumors of the larynx, localized in the supraglottic region, and classified as squamous cell carcinomas.
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