Prognostic values of stromal proportion and PCNA, Ki-67, and p53 proteins in patients with resected adenocarcinoma of the lung

Data from 64 patients who underwent surgical resection of lung adenocarcino mas were studied to identify clinicopathologic markers that might provide p rognostic information on the clinical behavior of this neoplasia. Patient s taging was performed in accordance with the tumor-node-metastasis system as follows: Stage I (n = 29), Stage II (n = 11), Stage IIIA (n = 21), and Sta ge IIIB (n = 3), Overall follow-up time corresponded to the follow-up time for patients who were alive and to the survival time for patients who had d ied, all of them expressed in months. Data included age, staging, histologi c type, morphometric assessment of histologic features related to tumor (st roma and vascularization), and immunohistochemical detection of proliferati on cell markers (Ki-67 protein and proliferating cell nuclear antigen) and p53 protein. The morphometric assessment was made by the point-counting pro cedure. Data analysis included Life Tables for Survival and Cox Regression models. Overall follow-up analysis showed that significant univariate predi ctors (P < .05) were T stage; N stage; tumor stromal proportion; and immuno histochemical indexes of proliferating cell nuclear antigen, Ki-67, and p53 proteins. Variables that presented independent predictive value for overal l follow-up with the multivariate model (P < .05) were sex, T stage, N stag e, tumor stromal proportion, and immunohistochemical detection of p53 prote in. We conclude that tumor stromal proportion and immunohistochemical detec tion of p53 protein, controlled for sex, T stage, and N stage, may be of cr itical value in the evaluation of recurrence of lung adenocarcinoma, servin g as indicators for a more accurate prognosis.