Angiogenesis as a Prognostic Indicator of Survival in Non-Small-Cell Lung Carcinoma: a Prospective Study

摘要: Background: Tumors acquire nutrients that are essential for continued growth and an avenue dissemination to the rest of body by inducing angiogenesis (i.e., formation new blood vessels). Preliminary studies involving a number different kinds cancer have indicated assessment tumor may be useful in predicting disease outcome. Purpose: In prospective study, we evaluated relationship between survival 407 patients with non-small-cell lung carcinoma who were treated potentially curative surgery. Methods: The study population consisted 360 male 47 female underwent surgery consecutively at Department Surgery, University Pisa, Italy, from March 1991 through December 1994. Follow-up lasted February 1996, median follow-up living 29 months (range, 15-60 months). An anti-CD34 monoclonal antibody, which is specific endothelial cells, standard immunohistochemical techniques used measure samples. Angiogenesis was quantified terms microvessel counts; counts single, high- power microscopic fields (magnification x250) three most intense areas vessel each sample averaged. count this series 20, categorized as follows : 1) low versus high (≤20 >20 microvessels) or 2) five categories (1-10, 11-20, 21-30, 31-40, ≥41 microvessels). Disease-free overall during assessed. Kaplan-Meier curves modeled univariate analysis patient characteristics; Cox proportional hazards model multivariate analysis. Reported P values two-sided. Results Conclusions: analysis, larger tumors (P trend <.00001), more advanced stage greater degree regional lymph node involvement vascularized (high count, P<.00001) experienced significantly reduced survival. When analyzed categories, highly significant (P<.00001) toward worse prognosis observed increasing vascularity. (P<.00001), size = .0006), status retained independent prognostic value respect survival; among these variables, considered continuous variable, important, relative hazard death 8.38 (95% confidence interval 4.19-16.78) associated highest counts. Implications: evaluation postsurgical staging identifying subsets benefit treatments.