title: The ratio of cancer cells to stroma after induction therapy in the treatment of non-small cell lung cancer.
abstract: OBJECTIVE
  Induction therapy induces degenerative changes of various degrees in both cancerous and non-cancerous cells of non-small cell lung cancer (NSCLC). The effect of induction therapy on histological characteristics, in particular the ratio of residual cancer cells to non-cancerous components, is unknown.
  
  
  METHODS
  Seventy-four NSCLC patients treated with induction therapy followed by surgery were enrolled. Residual cancer cells were identified using anti-pan-cytokeratin antibody (AE1/AE3). We analyzed and quantified the following three factors via digital image analysis; (1) the tumor area containing cancer cells and non-cancerous components (TA), (2) the total area of AE1/AE3 positive cancer cells (TACC), (3) the percentage of TACC to TA (%TACC). These factors were also analyzed in a matched control group (surgery alone, n = 80).
  
  
  RESULTS
  The median TACC of the induction therapy group was significantly lower than that of the control group (p < 0.01). In addition, the median %TACC of the induction therapy group (5.9 %) was significantly lower than that of the control group (58.6 %) (p < 0.01). TACC had a strong positive correlation with TA in the control group (r = 0.93), but not in the induction therapy group. Conversely, TACC had a strong positive correlation with %TACC in the induction therapy group (r = 0.95), but not in the control group.
  
  
  CONCLUSIONS
  Unlike the control group, the smaller the total area of residual cancer cells, the higher residual tumor contained non-cancerous components in the induction group, which may be the characteristic histological feature of NSCLC after induction therapy.
authors.affiliation: Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.|Department of Thoracic Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, Japan.|Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho Showa-ku, Nagoya, Aichi, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Goto
authors.affiliation: Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.|Department of Thoracic Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, Japan.
authors.forename: Masahito
authors.initials: M
authors.lastname: Naito
authors.affiliation: Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.|Department of Thoracic Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Saruwatari
authors.affiliation: Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.|Department of Thoracic Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, Japan.
authors.forename: Kakeru
authors.initials: K
authors.lastname: Hisakane
authors.affiliation: Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
authors.forename: Motohiro
authors.initials: M
authors.lastname: Kojima
authors.affiliation: Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Fujii
authors.affiliation: Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kuwata
authors.affiliation: Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ochiai
authors.affiliation: Biostatistics Division, Center for Research Administration and Support, National Cancer Center, 6-5-1 Kashiwanoha, Kashiwa, Chiba, Japan.
authors.forename: Shogo
authors.initials: S
authors.lastname: Nomura
authors.affiliation: Department of Thoracic Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, Japan.
authors.forename: Keiju
authors.initials: K
authors.lastname: Aokage
authors.affiliation: Department of Thoracic Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Hishida
authors.affiliation: Department of Thoracic Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Yoshida
authors.affiliation: Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho Showa-ku, Nagoya, Aichi, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Yokoi
authors.affiliation: Department of Thoracic Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tsuboi
authors.affiliation: Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan. gishii@east.ncc.go.jp.
authors.forename: Genichiro
authors.initials: G
authors.lastname: Ishii
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D002452:Cell Count; D059186:Chemoradiotherapy, Adjuvant; D005260:Female; D006801:Humans; D060828:Induction Chemotherapy; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D017154:Stromal Cells / Q000187:drug effects; D016896:Treatment Outcome; D047368:Tumor Burden
keywords: Cancer cell; Cancer stroma; Induction therapy; Non-small cell lung cancer