CHANGES DURING THE LAST DECADE IN CLINICAL-PARAMETERS OF OPERATED LUNG-CARCINOMA PATIENTS OF A CENTER FOR THORACIC-SURGERY AND THE PROGNOSTIC-SIGNIFICANCE OF TNM, MORPHOMETRIC, CYTOMETRIC, AND GLYCOHISTOCHEMICAL PROPERTIES
K. Kayser et al., CHANGES DURING THE LAST DECADE IN CLINICAL-PARAMETERS OF OPERATED LUNG-CARCINOMA PATIENTS OF A CENTER FOR THORACIC-SURGERY AND THE PROGNOSTIC-SIGNIFICANCE OF TNM, MORPHOMETRIC, CYTOMETRIC, AND GLYCOHISTOCHEMICAL PROPERTIES, The thoracic and cardiovascular surgeon, 45(4), 1997, pp. 196-199
Two sets of patients with potentially curative resection of primary ca
rcinomas operated in the Department of Thoracic Surgery, Thoraxklinik,
Heidelberg during the period 1983-1984 (cohort I), and in 1994 (cohor
t II) were analyzed. The survival of patients, postsurgical TNM-stages
, cell types, and exposure to potentially harmful substances were eval
uated. In addition, cytometric and morphometric techniques, and variou
s biotinylated markers have been applied to the tissue sections of the
1994 cohort; Cohort I comprised 282 patients (253 men and 29 women),
cohort II all in all 171 patients (121 men and 49 women). In cohort I
there were 262 heavy smokers, and 28 patients had a history of exposur
e to harmful enrivonmental substances (asbestos, polycyclic aromates,
etc.) compared to 145 smokers and 68 patients who inhaled potentially
harmful substances in cohort II. Major changes were also seen in early
lung cancer stages (pT1, pN0) which increased in cohort II, and in a
decrease in the relative frequency of epidermoid carcinomas in both me
n and women with corresponding increase in the frequency of adenocarci
noma in both sexes. The median survival of patients operated with adva
nced tumor stages had remained unchanged, that of early stages (pT1, p
N0, pN1) seems to have improved. Within the cytometric features syntac
tic structure analysis revealed that the current of structural entropy
is closely associated with the survival of patients. Of prognostic si
gnificance are, in addition, the expression of binding capacities to h
istoblood group trisaccharides A and H, the presence and the binding o
f macrophage migration inhibitory factor, and the presence of ligands
for the chicken liver galectin CL-16 and the Lewis(Y) antigen. Multiva
riant statistical analysis gave preferential prognostic importance to
the glycohistochemical and morphometric parameters relative to the cli
nical pi and pN stages in survival analysis.