Author/Editor		Lopert, Anton
Title		Pomen imunohistološke opredelitve drobnoceličnega pljučnega raka za prognozo bolnikov
Type		monografija
Place		Ljubljana
Publisher		Medicinska fakulteta
Publication year		1997
Volume		str. 55
Language		slo
Abstract		During the years 1985 - 93, there were 94% males among 51 patients, aged 38 - 75 years, treated for small cell lung cancer. Mostly passionate long-term smokers exhibit the most often change in the character of irritant cough, chest pain, dyspnea, and wasting, in 67%, 31%, 25%, 23% respectively. X-ray disclosed enlarged pulmonaiy hilus (37%), solitary coin lesion (33%) and enlarged mediastinum (31%). 72% of carcinomas were localised in upper lung lobes. The most common metastatic sites were bones (35%), lymph nodes (33%) and brain (31%). Mean survival time in 65% of patients with limited disease was 25 months in comparison with 9 months in patients with extensive disease.12% of patients survived 3 years. The combined treatment with surgery, chemotherapy and radiotherapy yielded the best survival, in average 35 months. The small cell cancer was confirmed histologically in 29 bronchial biopsies and in 22 lung resections: 47% of oat cell type,14% intermediate, and both types in 39%. Basophilia of vessel walls was seldom present in bronchial biopsy specimens (10%) compared with lung resections (41%). The results of immunohistological examinations were positive for pancytokeratin, low-molecular cytokeratin, neuron specific enolase, mostly focal chromogranin A in 31 %, 82%, 100% and 96%, respectively. Factors of cell proliferation, PCNA and Ki67 were positive in 100% and 46%, p53 protein was presented in 70% of cases. Infiltration of immunocompetent cells among tumor cancer cells was demonstrated in 20% of patients by the help of leucocyte common antigen, LCA. Statistically significant prognostic factors, determined by univariate analysis, were: the stage of disease, performance status, surgical treatment, immunohistologic demonstration of pancytokeratin, and demonstration of LCA in tumor stroma and among cancer cells. The later, and the stage of disease, were confirmed by multivariate analysis as statistically significant and independent prognostic factors.
Descriptors		LUNG NEOPLASMS CARCINOMA, SMALL CELL IMMUNOHISTOCHEMISTRY ADULT PROGNOSIS SURVIVAL ANALYSIS TUMOR MARKERS, BIOLOGICAL CYTOSKELETAL PROTEINS KERATIN PROLIFERATING CELL NUCLEAR ANTIGEN KI-67 ANTIGEN PHOSPHOPYRUVATE HYDRATASE CHROMOGRANINS ANTIGENS, CD45