title: Vascular diffusion density and survival of patients with primary lung carcinomas.
abstract: OBJECTIVE
  To investigate the clinical significance of tumour vascularisation in operated lung cancer patients.
  
  
  METHODS
  Histological slides obtained from 498 patients with potentially curative operated lung carcinomas in two different institutions of thoracic surgery were immunohistochemically stained with an anti-CD34 antibody and subjected to quantitative image analysis. Syntactic structure analysis measured the absolute and relative features of vessels, including the numerical tumour cells densities relative to their nearest neighbouring vessel. These data are associated with tumour volume, post-surgical TNM stage, and each patient's survival.
  
  
  RESULTS
  The clinical data, including sex distribution, age of patients, pTNM stages and survival, did not differ between the two institutions. The tumour vascularisation (volume fraction, Vv) amounted to 7% in lung carcinomas, was independent from cell type and increased in advanced tumour stages (pT4, pN3). Advanced tumour stages presented with a higher numerical vascular density and with maintained minimum diameter and circumference of vessels. Each patient's survival was closely associated with the pN stage, tumour volume, cell type and numerical density of tumour cells within a distance less than 20 micro m from the nearest neighbouring vessel due to multivariate statistical analysis.
  
  
  CONCLUSIONS
  Vascularisation of lung tumours becomes altered in advanced tumour stages. Of prognostic significance is the distribution of tumour cells in relation to the nearest neighbouring vessel only.
authors.affiliation: Institute of Pathology, University Freiburg, Germany. gkayser@ukl.uni-freiburg.de
authors.forename: Gian
authors.initials: G
authors.lastname: Kayser
authors.forename: Jan Dirk
authors.initials: JD
authors.lastname: Baumhäkel
authors.forename: Tamas
authors.initials: T
authors.lastname: Szöke
authors.forename: Imre
authors.initials: I
authors.lastname: Trojan
authors.forename: Urs
authors.initials: U
authors.lastname: Riede
authors.forename: Martin
authors.initials: M
authors.lastname: Werner
authors.forename: Klaus
authors.initials: K
authors.lastname: Kayser
mesh_terms: D000230:Adenocarcinoma / Q000098:blood supply / Q000473:pathology; D000368:Aged; D001808:Blood Vessels / Q000473:pathology*; D018288:Carcinoma, Small Cell / Q000098:blood supply / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000098:blood supply / Q000473:pathology; D002452:Cell Count; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000098:blood supply* / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate