Balance between cell division and cell death as predictor of survival in patients with non-small-cell lung cancer

Oncology. 2002;63(1):76-83. doi: 10.1159/000065724.

Abstract

Objective: To evaluate the prognostic value of the balance between apoptosis and proliferation in non-small-cell lung cancer (NSCLC).

Methods: Paraffin-embedded sections from a consecutive series of radically resected NSCLCs were scored for apoptosis (in situ DNA nick end labeling assay) and proliferation (immunohistochemistry for MIB-1). A total of 1,000 cells were counted per case, to obtain apoptotic (AI) and MIB-1 indices. Other potential prognostic indicators (pT, pN, pStage and histology) and p53 status were also evaluated.

Results: Univariate analysis showed that adenocarcinomatous histotype (p = 0.03), nodal involvement (p = 0.04), higher pStage (p = 0.001) and the combination of low AI and high MIB-1 expression (p = 0.03) were associated with poorer outcome. The significant prognostic value of the combination 'low AI/high MIB-1' was also confirmed in a multivariate analysis after adjustment for other covariates.

Conclusion: These results underline the importance of considering apoptosis and proliferation together to identify a subgroup of NSCLC associated with poor survival.

MeSH terms

  • Aged
  • Antigens, Nuclear
  • Apoptosis*
  • Carcinoma, Non-Small-Cell Lung / diagnosis*
  • Carcinoma, Non-Small-Cell Lung / metabolism
  • Carcinoma, Non-Small-Cell Lung / mortality
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Cell Division / physiology
  • Female
  • Humans
  • Immunohistochemistry
  • Ki-67 Antigen
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / metabolism
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology
  • Male
  • Middle Aged
  • Nuclear Proteins / biosynthesis
  • Prognosis
  • Survival Rate

Substances

  • Antigens, Nuclear
  • Ki-67 Antigen
  • Nuclear Proteins