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

Abstract

Two sets of patients with potentially curative resection of primary carcinomas operated in the Department of Thoracic Surgery, Thoraxklinik, Heidelberg during the period 1983-1984 (cohort I), and in 1994 (cohort II) were analyzed. The survival of patients, postsurgical TNM-stages, cell types, and exposure to potentially harmful substances were evaluated. In addition, cytometric and morphometric techniques, and various 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 exposure 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 (pTI, pNO) which increased in cohort II, and in a decrease in the relative frequency of epidermoid carcinomas in both men and women with corresponding increase in the frequency of adenocarcinoma in both sexes. The median survival of patients operated with advanced tumor stages had remained unchanged, that of early stages (pTI, pNO, pN1) seems to have improved. Within the cytometric features syntactic structure analysis revealed that the current of structural entropy is closely associated with the survival of patients. Of prognostic significance are, in addition, the expression of binding capacities to histoblood group trisaccharides A and H, the presence and the binding of macrophage migration inhibitory factor, and the presence of ligands for the chicken liver galectin CL-16 and the LewisY antigen. Multivariant Statistical analysis gave preferential prognostic importance to the glycohistochemical and morphometric parameters relative to the clinical pT and pN stages in survival analysis.

Key words

Lung Carcinoma - Survival - Cell type - Morphometry - Blood group - Galectin