TORAKOCHIRURGIA DNA ploidy as an independent prognostic factor: 10-year results in a group of patients surgically treated for squamous cell lung cancer

Abstract

StreszczenieWstęp: Duża zmienność biologiczna raka płuca powoduje, że mimo określonego typu histologicznego i stopnia zaawansowania raka wg klasyfikacji TNM przebieg choroby jest trudny do przewidzenia. Dlatego poszukuje się molekularnych i biochemicznych czynników mających znaczenie prognostyczne i pomocnych w kwalifikacji chorych do pooperacyjnej chemioterapii. Jednym z takich czynników mogą być zaburzenia zawartości DNA w komórkach nowotworowych, choć opinie na temat rokowniczego znaczenia ploidii są wśród badaczy podzielone. Celem pracy była ocena wpływu nieprawidłowej ilości DNA w komórkach raka na wyniki odległe (10-letnie) leczenia chirurgicznego raka płaskonabłonkowego płuca. Materiał i metody: Analizie poddano grupę 110 chorych leczonych operacyjnie z powodu raka płaskonabłonkowego płuca w latach 1995-1997. W badanej grupie było 95 mężczyzn i 15 kobiet w wieku 34-77 lat (średnia 60 lat). U 52 chorych wykonano lobektomię, u 47 pneumonektomię, a u 11 inne resekcje. Większość chorych operowano w stadium IB (35 chorych), IIB (26 pacjentów) i IIIA (22 chorych). Badany materiał stanowiły preparaty parafinowe, w których metodą cytometrii przepły-wowej zbadano zawartość DNA w komórkach raka. W każdym przypadku oznaczono indeks DNA, a ilość DNA w komórkach nowotworowych zilustrowano w postaci histogramów. Analizę statystyczną przeprowadzono przy użyciu program komputerowy Statistica 10.0 i oraz StatXact 8. Wyniki: Odsetek przypadków aneuploidalnych (z nieprawidło-wą ilością DNA) wyniósł 44,5%. Nie stwierdzono korelacji mię- AbstractBackground: The biological variability of lung cancer is one of the causes of the unpredictable clinical outcome of the disease. Many investigators have devoted a lot of effort to finding molecular and biochemical prognostic factors that may prove helpful in the qualification of patients for postoperative chemotherapy. Notwithstanding various previous studies attempted to associate DNA quantification in cancer cells with the prognosis for lung cancer, there is a divergence of opinion about its value. The aim of the present study was to assess the impact of aneuploidy on late (10-year) survival in a group of patients treated surgically for squamous cell lung cancer. Material and methods: We analyzed a group of 110 patients surgically treated for squamous cell lung cancer between 1995 and 1997. The group consisted of 95 men and 15 women, aged between 34 and 77 years (the average age being 60). We performed lobectomy in 52 cases, pneumonectomy in 47 cases, and other resections in 11 patients. Most of the patients were in IB (35 cases), IIB (26 patients) and IIIA (22 cases

Flow Cytometric Measurement of Aneuploid DNA Content Correlates with High S-Phase Fraction and Poor Prognosis in Patients with Non-Small-Cell Lung Cancer

“…In the present work, we observed the aneuploid DNA content in about half of the NSCLC samples. Similar to other reports, no differences between DNA content and gender, age of patients, pathologic stage, tumor size, grade of differentiation, degree of cell pleomorphism, and index of tumor necrosis were obtained [23,25]. Nevertheless, the aneuploidy was found to be associated with a poor overall survival of NSCLC patients, not depending on the histopathological subtype of tumor.…”

“…In lung cancer, DNA content abnormalities have been described as a heterogeneous spectrum in DNA histogram patterns of impaired tumor cell [22]. Aneuploid DNA content has been found between 44.5-84.8% of NSCLC using flow cytometric analysis from archival formalin-fixed and paraffin-embedded specimens [12,14,23,24]. In the present work, we observed the aneuploid DNA content in about half of the NSCLC samples.…”

“…In aneuploid NSCLC, a greater tendency to displayed local recurrence, lymph node and/or distant metastasis was noted as compared with diploid tumors. In similar reports, more patients with aneuploid cancers died from distant metastasis, whereas local cancer recurrence was more frequent in patients with diploid tumors [23]. Additionally, in aneuploid NSCLC, a greater tendency to invade lymphatic vessels and more metastasis in regional lymph nodes were evidenced [12].…”

“…Nevertheless, the aneuploidy was found to be associated with a poor overall survival of NSCLC patients, not depending on the histopathological subtype of tumor. It is known, aneuploidy has been usually related to an aggressive biological behavior of many malignant tumors [26] including lung cancers [12,21,23,25]. In previous reports, other authors have obtained significant differences dependent on ploidy in both overall survival and disease-free survival in NSCLC [12,23].…”

“…It is known, aneuploidy has been usually related to an aggressive biological behavior of many malignant tumors [26] including lung cancers [12,21,23,25]. In previous reports, other authors have obtained significant differences dependent on ploidy in both overall survival and disease-free survival in NSCLC [12,23]. However, in the majority of these studies, only squamous cell carcinoma was included, probably to avoid the potential impact of histologic type of the tumor on the survival rate [23,25] or this subtype predominated in the series [12].…”