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


CONCLUSIONS
These results underline the importance of considering apoptosis and proliferation together to identify a subgroup of NSCLC associated with poor survival.
Clinical Oncology, DRMM, University of Udine, Udine, Italy. fabio.puglisi@med.uniud.it
Fabio
F
Puglisi
Alessandro Marco
AM
Minisini
Giuseppe
G
Aprile
Fabio
F
Barbone
Palmina
P
Cataldi
Daria
D
Artico
Giuseppe
G
Damante
Carlo Alberto
CA
Beltrami
Carla
C
Di Loreto
D000368:Aged; D034961:Antigens, Nuclear; D017209:Apoptosis; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000378:metabolism / Q000401:mortality / Q000473:pathology; D002455:Cell Division / Q000502:physiology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009687:Nuclear Proteins / Q000096:biosynthesis; D011379:Prognosis; D015996:Survival Rate
D034961:Antigens, Nuclear; D019394:Ki-67 Antigen; D009687:Nuclear Proteins