TUMOR ANGIOGENESIS AS A PROGNOSTIC MARKER IN OPERABLE NONSMALL CELL LUNG-CANCER

Background. Recent evidence suggests that tumor angiogenesis is associ ated with patient outcome in a number of malignancies. However, little is known about the significance of tumor microvessel density as evalu ated by an anti-CD34 antibody in patients with lung cancer. Methods. T umor tissues were obtained from 101 patients with operable non-small c ell lung cancers. Immunohistochemical detection of tumor-associated mi crovessels was performed using anti-CD34 antibodies directed against e ndothelial markers. Average counts of the three most vascular areas on a x200 field were recorded. Results. Staining for CD34 was easy to in terpret because of specific and minimal background staining. The Kapla n-Meier method showed a statistically significant difference between t he microvessel count and overall survival. The microvessel count was i dentified as the only significant and independent prognostic marker. I n both univariate and multivariate analyses, the microvessel count was significantly related to the development of hematogenous metastasis b ut failed to associate with the development of nodal metastasis. Concl usions. Tumor vascularity is an independent prognostic factor and impo rtant for the development of hematogenous metastasis. (C) 1998 by The Society of Thoracic Surgeons.