Tumour necrosis is an independent prognostic marker in non-small cell lung cancer : correlation with biological variables

Swinson, Daniel E. B., Jones, J. Louise, Richardson, Donna, Cox, Giles, Edwards, John G., & O'Byrne, Kenneth J. (2002) Tumour necrosis is an independent prognostic marker in non-small cell lung cancer : correlation with biological variables. Lung Cancer, 37(3), pp. 235-240.

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Background Tumour necrosis (TN) is recognized to be a consequence of chronic cellular hypoxia. TN and hypoxia correlate with poor prognosis in solid tumours.

Methods In a retrospective study the prognostic implications of the extent of TN was evaluated in non-small cell lung cancer (NSCLC) and correlated with clinicopathological variables and expression of epidermal growth factor receptor, Bcl-2, p53 and matrix metalloproteinase-9 (MMP-9). Tissue specimens from 178 surgically resected cases of stage I-IIIA NSCLC with curative intent were studied. The specimens were routinely processed, formalin-fixed and paraffin-embedded. TN was graded as extensive or either limited or absent by two independent observers; disagreements were resolved using a double-headed microscope. The degree of reproducibility was estimated by re-interpreting 40 randomly selected cases after a 4 month interval.

Results Reproducibility was attained in 36/40 cases, Kappa score=0.8 P<0.001. TN correlated with T-stage (P=0.001), platelet count (P=0.004) and p53 expression (P=0.031). Near significant associations of TN with N-stage (P=0.063) and MMP-9 expression (P=0.058) were seen. No association was found with angiogenesis (P=0.98). On univariate (P=0.0016) and multivariate analysis (P=0.023) TN was prognostic.

Conclusion These results indicate that extensive TN reflects an aggressive tumour phenotype in NSCLC and may improve the predictive power of the TMN staging system. The lack of association between TN and angiogenesis may be important although these variables were not evaluated on serial sections. © 2002 Elsevier Science Ireland Ltd. All rights reserved.

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ID Code: 65721
Item Type: Journal Article
Refereed: Yes
Additional URLs:
Keywords: Epidermal growth factor receptor, Matrix metalloproteinase-9, p53, Platelet count, Tumour necrosis, formaldehyde, gelatinase B, paraffin, protein bcl 2, protein p53, adult, angiogenesis, article, cancer adjuvant therapy, cancer staging, cancer surgery, cancer survival, controlled study, embryo, female, histopathology, human, human tissue, immunohistochemistry, lung non small cell cancer, major clinical study, male, phenotype, prediction, priority journal, prognosis, protein expression, reproducibility, retrospective study, thrombocyte count, tumor necrosis, Aged, Carcinoma, Non-Small-Cell Lung, Disease Progression, Humans, Lung Neoplasms, Middle Aged, Neoplasm Staging, Reproducibility of Results, Retrospective Studies, Survival, Tumor Markers, Biological, Tumor Necrosis Factor-alpha, Tumor Suppressor Protein p53
DOI: 10.1016/S0169-5002(02)00172-1
ISSN: 0169-5002
Divisions: Current > Schools > School of Biomedical Sciences
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2002 Elsevier Ireland Ltd
Deposited On: 07 Jan 2014 07:07
Last Modified: 07 Jan 2014 07:08

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