Prognostic significance of microvascularization in cases of operated lung cancer.
OBJECTIVE
Measurement of microvascularization and determination of its prognostic significance in cases of lung cancer.


METHODS
Section prepared from histological material from 432 radically operated non-small cell lung cancer patients were stained with antibodies against factor VIII-associated antigen. During computer imaging, the absolute and relative parameters of the vascularization were determined, as was the density of tumour cells situated in the vicinity of the vessels. The results were compared with the TNM status, the cell type and the survival.


RESULTS
Each parameter demonstrated an enhanced vascularization in classifications T2 and T4, but only the surface fraction, the mean vascular circumference and the mean vascular area displayed a significant change. The microvascularization parameters did not differ significantly between with different N status, however, the cell density progressively increased in the areas close to the vessels in advanced pN classifications. Elevation of the tumour cell density within 20 microm distance of the vessels was accompanied by a significantly poorer survival rate. The density of tumour cells within 20 microm region was the second strongest prognostic factor after the N status.


CONCLUSIONS
More advanced tumour classifications grow with enhanced vascularization. A clear-cut connection cannot be demonstrated between the vascularization and appearance of lymph node metastases. The density of tumour cells measured in the direct vicinity of vessels is an important prognostic factor.
Szöke
Tamas
T
Department of Surgery, University of Szeged, Pécsi u.4., H-6720 Szeged, Hungary. szoketama@hotmail.com
Kayser
Klaus
K
Baumhäkel
Jan-Dirk
JD
Trojan
Imre
I
Furak
Jozsef
J
Tiszlavicz
Laszlo
L
Eller
Jozsef
J
Boda
Krisztina
K
D000230:Adenocarcinoma / Q000098:blood supply* / Q000473:pathology / Q000601:surgery; D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000032:analysis; D002289:Carcinoma, Non-Small-Cell Lung / Q000098:blood supply* / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000098:blood supply* / Q000473:pathology / Q000601:surgery; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008175:Lung Neoplasms / Q000098:blood supply* / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D014841:von Willebrand Factor / Q000032:analysis
D015415:Biomarkers; D014841:von Willebrand Factor