This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Tanaka, F. Articles by Wada, H. Search for Related Content PubMed PubMed Citation Articles by Tanaka, F. Articles by Wada, H. Social Bookmarking                            What's this?

Prognostic Significance of Apoptotic Index in Completely Resected Non–Small-Cell Lung Cancer

From the Department of Thoracic Surgery, Faculty of Medicine, Kyoto University, Kyoto, Japan.

Address reprint requests to Hiromi Wada, MD, Department of Thoracic Surgery, Faculty of Medicine, Kyoto University, Shogoin-kawahara-cho 53, Sakyo-ku, Kyoto, 606-8397, Japan; email wada{at}frontier.kyoto-m.ac.jp

PURPOSE: To evaluate the significance of apoptotic index (AI) as a prognostic factor after surgery for non–small-cell lung cancer (NSCLC).

PATIENTS AND METHODS: A total of 236 patients who underwent surgery for previously untreated pathologic stage I to IIIa NSCLC between 1985 and 1990 were reviewed. AI was defined as the number of apoptotic cells, detected by terminal deoxynucleotidyl transferase–mediated deoxyuridine triphosphate-biotin nick end-labeling, per 1,000 tumor cells. Proliferative index (PI) and aberrant p53 expression were also evaluated immunohistochemically.

RESULTS: The 5-year survival rate for the lowest-AI group (AI < 5.0) was 74.7%; those for the lower-AI group (5.0 AI < 11.0) and the higher-AI group (11.0 AI < 25.0) were 51.6% and 57.8%, respectively. These survival rates were significantly lower than that of the lowest-AI group (P = .021 and P = .043, respectively). The highest-AI group (25.0 AI), however, showed the most favorable prognosis, with a 5-year survival rate of 83.2%. Multivariate analysis confirmed that a moderate AI (5.0 AI < 11.0 or 11.0 AI < 25.0) was a significant factor to predict poor prognosis. The PIs for the lowest-, the lower-, the higher-, and the highest-AI groups were 32.3%, 48.0%, 54.3%, and 50.7%, respectively. The lowest-AI group showed a favorable prognosis because of its low PI, whereas the lower- and the higher-AI groups had a poor prognosis caused by increased cancer-cell proliferation. The highest-AI group showed the most favorable prognosis because apoptotic cell death overcame cell proliferation. No significant correlation was observed between AI and aberrant p53 expression.

CONCLUSION: AI proved to be an independent prognostic factor in NSCLC.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				S. Ishikawa, T. Nakagawa, R. Miyahara, Y. Kawano, K. Takenaka, K. Yanagihara, Y. Otake, H. Katakura, H. Wada, and F. Tanaka Expression of MDA-7/IL-24 and Its Clinical Significance in Resected Non-Small Cell Lung Cancer Clin. Cancer Res., February 1, 2005; 11(3): 1198 - 1202. [Abstract] [Full Text] [PDF]

				S. Ishikawa, K. Takenaka, K. Yanagihara, R. Miyahara, Y. Kawano, Y. Otake, S. Hasegawa, H. Wada, and F. Tanaka Matrix Metalloproteinase-2 Status in Stromal Fibroblasts, Not in Tumor Cells, Is a Significant Prognostic Factor in Non-Small-Cell Lung Cancer Clin. Cancer Res., October 1, 2004; 10(19): 6579 - 6585. [Abstract] [Full Text] [PDF]

				F. Tanaka, K. Takenaka, H. Oyanagi, T. Fujinaga, Y. Otake, K. Yanagihara, H. Ito, and H. Wada Skip mediastinal nodal metastases in non-small cell lung cancer Eur. J. Cardiothorac. Surg., June 1, 2004; 25(6): 1114 - 1120. [Abstract] [Full Text] [PDF]

				F. Tanaka, H. Oyanagi, K. Takenaka, S. Ishikawa, K. Yanagihara, R. Miyahara, Y. Kawano, M. Li, Y. Otake, and H. Wada Glomeruloid Microvascular Proliferation Is Superior to Intratumoral Microvessel Density as a Prognostic Marker in Non-Small Cell Lung Cancer Cancer Res., October 15, 2003; 63(20): 6791 - 6794. [Abstract] [Full Text] [PDF]

				F. Tanaka, S. Ishikawa, K. Yanagihara, R. Miyahara, Y. Kawano, M. Li, Y. Otake, and H. Wada Expression of Angiopoietins and Its Clinical Significance in Non-Small Cell Lung Cancer Cancer Res., December 1, 2002; 62(23): 7124 - 7129. [Abstract] [Full Text] [PDF]

				H. Joensuu, A. Anttonen, M. Eriksson, R. Makitaro, H. Alfthan, V. Kinnula, and S. Leppa Soluble Syndecan-1 and Serum Basic Fibroblast Growth Factor Are New Prognostic Factors in Lung Cancer Cancer Res., September 15, 2002; 62(18): 5210 - 5217. [Abstract] [Full Text] [PDF]

				T. Shoji, F. Tanaka, T. Takata, K. Yanagihara, Y. Otake, N. Hanaoka, R. Miyahara, T. Nakagawa, Y. Kawano, S. Ishikawa, et al. Clinical Significance of p21 Expression in Non-Small-Cell Lung Cancer J. Clin. Oncol., September 15, 2002; 20(18): 3865 - 3871. [Abstract] [Full Text] [PDF]

				M. D. Brundage, D. Davies, and W. J. Mackillop Prognostic Factors in Non-small Cell Lung Cancer* : A Decade of Progress Chest, September 1, 2002; 122(3): 1037 - 1057. [Abstract] [Full Text] [PDF]

				H. Katakura, F. Tanaka, H. Oyanagi, R. Miyahara, K. Yanagihara, Y. Otake, and H. Wada Clinical significance of nm23 expression in resected pathologic-stage I, non-small cell lung cancer Ann. Thorac. Surg., April 1, 2002; 73(4): 1060 - 1064. [Abstract] [Full Text] [PDF]

				F. Tanaka, Y. Otake, K. Yanagihara, Y. Kawano, R. Miyahara, M. Li, T. Yamada, N. Hanaoka, K. Inui, and H. Wada Evaluation of Angiogenesis in Non-small Cell Lung Cancer: Comparison between Anti-CD34 Antibody and Anti-CD105 Antibody Clin. Cancer Res., November 1, 2001; 7(11): 3410 - 3415. [Abstract] [Full Text] [PDF]

				C. G. Ferreira, P. van der Valk, S. W. Span, I. Ludwig, E. F. Smit, F. A. E. Kruyt, H. M. Pinedo, H. van Tinteren, and G. Giaccone Expression of X-linked Inhibitor of Apoptosis as a Novel Prognostic Marker in Radically Resected Non-Small Cell Lung Cancer Patients Clin. Cancer Res., August 1, 2001; 7(8): 2468 - 2474. [Abstract] [Full Text] [PDF]

				F. Tanaka, K. Yanagihara, Y. Otake, T. Yamada, T. Shoji, R. Miyahara, K. Inui, and H. Wada Prognostic factors in patients with resected pathologic (p-) T1-2N1M0 non-small cell lung cancer (NSCLC) Eur. J. Cardiothorac. Surg., May 1, 2001; 19(5): 555 - 561. [Abstract] [Full Text] [PDF]

				F. Tanaka, K. Yanagihara, Y. Otake, M. Li, R. Miyahara, H. Wada, and H. Ito Biological features and preoperative evaluation of mediastinal nodal status in non-small cell lung cancer Ann. Thorac. Surg., December 1, 2000; 70(6): 1832 - 1838. [Abstract] [Full Text] [PDF]