title: Prognostic significance of the proliferation index in surgically resected non-small-cell lung cancer.
abstract: OBJECTIVE
  To determine the utility of measuring the tumor proliferation index as a prognostic marker in patients with non-small-cell lung cancer.
  
  
  METHODS
  Immunostaining for the proliferation-associated antigen Ki-67, quantitated using computer-assisted image cytometry, was used to derive the tumor proliferation index for 61 fresh-frozen, banked specimens of non-small-cell lung cancer. DNA ploidy was measured concomitantly for all specimens. A median follow-up of 38 months was achieved for survival analyses.
  
  
  METHODS
  A large southeastern United States private referral institution and affiliated hospital provided the study environment.
  
  
  METHODS
  A consecutive, convenience sample of 61 patients was enrolled based on resected tissue preservation and viability over a five-year accruement.
  
  
  METHODS
  Significant associations between DNA content, proliferation index, established clinicopathological parameters, and outcome were examined.
  
  
  RESULTS
  A significant inverse association between patient survival and tumor proliferation index was found that was independent of other established clinicopathological predictors of outcome. Patients whose tumors harbored a proliferation index of less than 3.5 survived significantly longer than patients with tumors demonstrating higher values. No association between DNA content and proliferation index was uncovered.
  
  
  CONCLUSIONS
  Measurement of the proliferation index, as derived from quantitative Ki-67 immunostaining and analyzed by image cytometry, may provide significant complementary, if not independent, prognostic information for patients with non-small-cell lung cancer.
authors.affiliation: Department of Surgery, Duke University Medical Center, Durham, NC.
authors.forename: J C
authors.initials: JC
authors.lastname: Pence
authors.forename: B J
authors.initials: BJ
authors.lastname: Kerns
authors.forename: R K
authors.initials: RK
authors.lastname: Dodge
authors.forename: J D
authors.initials: JD
authors.lastname: Iglehart
mesh_terms: D000368:Aged; D001706:Biopsy; D002289:Carcinoma, Non-Small-Cell Lung / Q000737:chemistry / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D004273:DNA, Neoplasm / Q000032:analysis*; D003936:Diagnosis, Computer-Assisted; D005260:Female; D005434:Flow Cytometry / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D019394:Ki-67 Antigen; D008175:Lung Neoplasms / Q000737:chemistry / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D008264:Macrophages; D008297:Male; D008875:Middle Aged; D008940:Mitotic Index; D009363:Neoplasm Proteins / Q000032:analysis*; D009367:Neoplasm Staging; D009687:Nuclear Proteins / Q000032:analysis*; D011003:Ploidies; D011379:Prognosis; D016016:Proportional Hazards Models; D015203:Reproducibility of Results; D016019:Survival Analysis
chemical_list: D004273:DNA, Neoplasm; D019394:Ki-67 Antigen; D009363:Neoplasm Proteins; D009687:Nuclear Proteins