CELL-KINETICS ANALYSIS OF SURGICALLY RESECTED NONSMALL CELL-CARCINOMAOF THE LUNG USING THE AGNOR SILVER STAIN

Cell kinetics analysis of lung carcinoma using DNA flow cytometry has shown a significant correlation with the biological behavior of these neoplasms. Ploidy has shown a more significant association with aggres sive behavior. The method may however not be available in all centers. Two counts of the AgNOR silver stain have been correlated with ploidy and proliferative activity (PA). The first count, which is the mean n umber of AgNOR granules (mAgNOR), correlates with ploidy. The second c ount is the percentage of cells with greater than or equal to 5 AgNORs /nucleus (pAgNOR), reflects PA. We performed the AgNOR silver stain us ing the two above-mentioned counts in 41 cases of surgically resected non-small cell carcinoma of the lung. The cases included 14 adenocarci nomas, 24 squamous cell carcinomas, and three undifferentiated non-sma ll cell carcinomas. Follow-up data were available on 36 of the patient s, ranging from 10 to 31 months (median 18 months). Thirteen of these patients (36%) developed progressive disease. Adenocarcinomas showed m AgNOR counts suggestive of aneuploidy (greater than or equal to 2.4) i n nine of the 14 patients (64%) and 16 of the 24 squamous carcinomas ( 66%). The adenocarcinomas showed high pAgNOR counts (greater than or e qual to 8%) in eight of the 14 cases (57%), in contrast to 15 of the 2 4 squamous carcinomas (62%). The AgNOR counts did not show any statist ically significant correlation with tumor type, grade or stage of dise ase. The mAgNOR counts were aneuploid in all 13 progressive cases and in only 10 of the 23 stable cases (43%) (P=0.001). The pAgNOR counts w ere high in 12 of the 13 cases that progressed (92%), in contrast to 1 0 of the 23 stable cases (43%) (P=0.01). Then is no significant eviden ce that squamous carcinoma of the lung may have a higher incidence of aneuploidy and high PA than adenocarcinoma. Our data also confirm prev ious data showing that aneuploid lung carcinomas have more aggressive behavior than diploid ones. This study also indicates that, despite th e short-term follow-up data, the use of the AgNOR silver stain for cel l kinetics analysis of non-small eel carcinoma of the lung may potenti ally provide useful predictive information on the biologic behavior of lung carcinoma. Long-term follow-up may provide more significant info rmation.