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Marias K, Dionysiou D, Sakkalis V, Graf N, Bohle RM, Coveney PV, Wan S, Folarin A, Büchler P, Reyes M, Clapworthy G, Liu E, Sabczynski J, Bily T, Roniotis A, Tsiknakis M, Kolokotroni E, Giatili S, Veith C, Messe E, Stenzhorn H, Kim YJ, Zasada S, Haidar AN, May C, Bauer S, Wang T, Zhao Y, Karasek M, Grewer R, Franz A, Stamatakos G. Clinically driven design of multi-scale cancer models: the ContraCancrum project paradigm. Interface Focus 2011; 1:450-61. [PMID: 22670213 PMCID: PMC3262443 DOI: 10.1098/rsfs.2010.0037] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Accepted: 03/07/2011] [Indexed: 12/13/2022] Open
Abstract
The challenge of modelling cancer presents a major opportunity to improve our ability to reduce mortality from malignant neoplasms, improve treatments and meet the demands associated with the individualization of care needs. This is the central motivation behind the ContraCancrum project. By developing integrated multi-scale cancer models, ContraCancrum is expected to contribute to the advancement of in silico oncology through the optimization of cancer treatment in the patient-individualized context by simulating the response to various therapeutic regimens. The aim of the present paper is to describe a novel paradigm for designing clinically driven multi-scale cancer modelling by bringing together basic science and information technology modules. In addition, the integration of the multi-scale tumour modelling components has led to novel concepts of personalized clinical decision support in the context of predictive oncology, as is also discussed in the paper. Since clinical adaptation is an inelastic prerequisite, a long-term clinical adaptation procedure of the models has been initiated for two tumour types, namely non-small cell lung cancer and glioblastoma multiforme; its current status is briefly summarized.
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Affiliation(s)
- K. Marias
- Institute of Computer Science at FORTH, Heraklion, Greece
| | - D. Dionysiou
- In Silico Oncology Group, Institute of Communications and Computer Systems, National Technical University of Athens, Athens, Greece
| | - V. Sakkalis
- Institute of Computer Science at FORTH, Heraklion, Greece
| | - N. Graf
- Departments of Paediatric Oncology and Haematology, Pathology, Genetics, Universität des Saarlandes, Homburg, Germany
| | - R. M. Bohle
- Departments of Paediatric Oncology and Haematology, Pathology, Genetics, Universität des Saarlandes, Homburg, Germany
| | - P. V. Coveney
- Centre for Computational Science, Department of Chemistry, University College London, 20 Gordon Street, London WC1H 0AJ, UK
| | - S. Wan
- Centre for Computational Science, Department of Chemistry, University College London, 20 Gordon Street, London WC1H 0AJ, UK
| | - A. Folarin
- Cancer Research Institute, University College London, 72 Huntley Street, London WC1E 6BT, UK
| | - P. Büchler
- Institute for Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland
| | - M. Reyes
- Institute for Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland
| | - G. Clapworthy
- Department of Computer Science & Technology, University of Bedfordshire, Luton, UK
| | - E. Liu
- Department of Computer Science & Technology, University of Bedfordshire, Luton, UK
| | - J. Sabczynski
- Philips Technologie GmbH, Innovative Technologies, Hamburg, Germany
| | - T. Bily
- Faculty of Mathematics and Physics, Department of Applied Mathematics, Charles University in Prague, Prague, Czech Republic
| | - A. Roniotis
- Institute of Computer Science at FORTH, Heraklion, Greece
| | - M. Tsiknakis
- Institute of Computer Science at FORTH, Heraklion, Greece
| | - E. Kolokotroni
- In Silico Oncology Group, Institute of Communications and Computer Systems, National Technical University of Athens, Athens, Greece
| | - S. Giatili
- In Silico Oncology Group, Institute of Communications and Computer Systems, National Technical University of Athens, Athens, Greece
| | - C. Veith
- Departments of Paediatric Oncology and Haematology, Pathology, Genetics, Universität des Saarlandes, Homburg, Germany
| | - E. Messe
- Departments of Paediatric Oncology and Haematology, Pathology, Genetics, Universität des Saarlandes, Homburg, Germany
| | - H. Stenzhorn
- Departments of Paediatric Oncology and Haematology, Pathology, Genetics, Universität des Saarlandes, Homburg, Germany
| | - Yoo-Jin Kim
- Departments of Paediatric Oncology and Haematology, Pathology, Genetics, Universität des Saarlandes, Homburg, Germany
| | - S. Zasada
- Centre for Computational Science, Department of Chemistry, University College London, 20 Gordon Street, London WC1H 0AJ, UK
| | - A. N. Haidar
- Centre for Computational Science, Department of Chemistry, University College London, 20 Gordon Street, London WC1H 0AJ, UK
| | - C. May
- Institute for Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland
| | - S. Bauer
- Institute for Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland
| | - T. Wang
- Department of Computer Science & Technology, University of Bedfordshire, Luton, UK
| | - Y. Zhao
- Department of Computer Science & Technology, University of Bedfordshire, Luton, UK
| | - M. Karasek
- Faculty of Mathematics and Physics, Department of Applied Mathematics, Charles University in Prague, Prague, Czech Republic
| | - R. Grewer
- Philips Technologie GmbH, Innovative Technologies, Hamburg, Germany
| | - A. Franz
- Philips Technologie GmbH, Innovative Technologies, Hamburg, Germany
| | - G. Stamatakos
- In Silico Oncology Group, Institute of Communications and Computer Systems, National Technical University of Athens, Athens, Greece
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Sardari Nia P, Van Marck E, Van Schil P. The Prospect of Biologic Staging of Non–Small-Cell Lung Cancer. Clin Lung Cancer 2005; 6:217-24. [PMID: 15694013 DOI: 10.3816/clc.2005.n.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The reductionistic approach to cancer research has led to an enormous amount of information and publications regarding the molecular biologic processes that take place in cancer tissue. However, the specific influence of this information on clinical practice has been limited. With the advent of new reductionistic tools like the transcriptomic and proteomic technologies, many would argue that further advances in the field of lung cancer research will be dominated by advances on the technical level. However, we anticipate that the most revolutionary advances will be those at a conceptual level. Medical science has always been reductionistic in essence, reducing and analyzing the composing elements of our complex biologic machinery, overlooking the fact that the interrelation among a set of simple determinants creates a new dimension of characteristics and functions. Problems emerging from a reductionistic approach are heterogeneity and variability. This review addresses the current conceptual problems in the field of lung cancer biology and provides a new conceptual model based on recent publications.
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Affiliation(s)
- Peyman Sardari Nia
- Department of Thoracic and Vascular Surgery University Hospital of Antwerp, Edegem, Belgium
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3
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Brundage MD, Davies D, Mackillop WJ. Prognostic factors in non-small cell lung cancer: a decade of progress. Chest 2002; 122:1037-57. [PMID: 12226051 DOI: 10.1378/chest.122.3.1037] [Citation(s) in RCA: 453] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
STUDY OBJECTIVES To provide a systematic overview of the literature investigating patient and tumor factors that are predictive of survival for patients with non-small cell lung cancer (NSCLC), and to analyze patterns in the design of these studies in order to highlight problematic aspects of their design and to advocate for appropriate directions of future studies. DESIGN A systematic search of the MEDLINE database and a synthesis of the identified literature. MEASUREMENTS AND RESULTS The database search (January 1990 to July 2001) was carried out combining the MeSH terms prognosis and carcinoma, nonsmall cell lung. Eight hundred eighty-seven articles met the search criteria. These studies identified 169 prognostic factors relating either to the tumor or the host. One hundred seventy-six studies reported multivariate analyses. Concerning 153 studies reporting a multivariate analysis of prognostic factors in patients with early-stage NSCLC, the median number of patients enrolled per study was 120 (range, 31 to 1,281 patients). The median number of factors reported to be significant in univariate analyses was 4 (range, 2 to 14 factors). The median number of factors reported to be significant in multivariate analyses per study was 2 (range, 0 to 6 factors). The median number of studies examining each prognostic factor was 1 (range, 1 to 105 studies). Only 6% of studies addressed clinical outcomes other than patient survival. CONCLUSIONS While the breadth of prognostic factors studied in the literature is extensive, the scope of factors evaluated in individual studies is inappropriately narrow. Individual studies are typically statistically underpowered and are remarkably heterogeneous with regard to their conclusions. Larger studies with clinically relevant modeling are required to address the usefulness of newly available prognostic factors in defining the management of patients with NSCLC.
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Affiliation(s)
- Michael D Brundage
- Department of Oncology, Radiation Oncology Research Unit, Queen's University, Kingston, ON, Canada.
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4
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Abstract
Non-small cell lung cancer (NSCLC) is a malignant tumor with poor prognosis. Although the prognostic variables determining short-term survival have been well described, relatively little attention has been paid to factors associated with long-term survival. In search of these factors we studied the expression of several molecular markers in NSCLC. Only tumor samples of patients with squamous cell carcinomas and stage III tumors with a postoperative survival of at least 5 years and those of patients who died within 2 years after resection were selected for this study. The expression of several parameters including oncogene and suppressor gene products, proliferative, apoptotic, angiogenic and resistance-related factors were investigated and the differences in these two extreme populations were determined by the Wilcoxon rank sum test. Factors involved in proliferation (ras, fos, erbB-1, jun, cyclin A) were downregulated whereas factors involved in apoptosis (p53, bcl-2, CD95) were upregulated in the long survival group. Direct measurement of parameters of proliferation (cell cycle analysis by flow cytometry, PCNA index) revealed a lower proliferative activity in tumors of the long survivors compared to short survivors. In conclusion, tumors of the long survival group are characterized by a downregulation of factors involved in proliferation and an upregulation of factors involved in apoptosis. These tumors may grow more slowly and this may influence long-term survival of patients with NSCLC.
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Affiliation(s)
- Jürgen Mattern
- Department E0600, German Cancer Research Center, Im Neuenheimer Feld 280, D-69120, Heidelberg, Germany.
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5
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Daidone MG, Costa A, Silvestrini R. Cell proliferation markers in human solid tumors: assessing their impact in clinical oncology. Methods Cell Biol 2001; 64:359-84. [PMID: 11070848 DOI: 10.1016/s0091-679x(01)64022-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- M G Daidone
- Instituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy
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6
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Sugahara S, Ohara K, Takahashi A, Irie T, Watanabe T, Tanaka N, Nozawa K, Nakajima K, Itai Y. Prognostic significance of the PC10 index for patients with stage II and III oesophageal cancer treated with radiotherapy. Acta Oncol 2000; 38:1057-62. [PMID: 10665763 DOI: 10.1080/028418699432365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
The monoclonal antibody PC10 is used for immunohistochemical staining of the proliferating cell nuclear antigen (PCNA). The percentage of PC10-positive cancer cells is defined as the PC10 index. We evaluated the relationship between the PC10 index in pretreatment endoscopic biopsies and the prognoses of 47 patients with Stage II-III oesophageal squamous cell carcinoma treated with radiotherapy. The patients with a PC10 index > 40% had significantly poorer prognoses than the other patients (p = 0.0007). Proportional hazards model analysis indicated that only the PC10 index was a prognostic factor (p = 0.0009). The patient group of complete responders showed significantly lower PC10 indices compared to patients with a partial response or no change (p = 0.049). The PC10 index can be a good predictive indicator of the prognosis in patients with Stage II-III oesophageal cancer treated with radiotherapy.
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Affiliation(s)
- S Sugahara
- Department of Radiology, Hitachi General Hospital, Hitachi-shi, Ibaraki, Japan.
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7
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Sørensen JB, Østerlind K. Prognostic Factors: From Clinical Parameters to New Biological Markers. ACTA ACUST UNITED AC 1999. [DOI: 10.1007/978-3-642-59824-1_1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2023]
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8
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Costa A, Silvestrini R, Mochen C, Lequaglie C, Boracchi P, Faranda A, Vessecchia G, Ravasi G. P53 expression, DNA ploidy and S-phase cell fraction in operable locally advanced non-small-cell lung cancer. Br J Cancer 1996; 73:914-9. [PMID: 8611406 PMCID: PMC2074267 DOI: 10.1038/bjc.1996.163] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The identification of biomarkers to complement pathological stage for a more accurate prognosis and help clinicians decide on treatment is still an open problem for patients with lung cancer. Expression of P53 protein was detected by an immunohistochemical approach using the monoclonal antibody PAb1801 on paraffin-embedded sections of tumours obtained surgically from 102 stage II - IIIa patients with non-small-cell lung cancer (52 squamous cell carcinomas, 50 adenocarcinomas). [3H]Thymidine labelling index, an indicator of the S-phase cell fraction, was evaluated on histological sections of [3H]thymidine-labelled tumour samples. DNA ploidy was defined by flow cytometric analysis on frozen tumour tissue. The biomarkers, histology and pathological stage were analysed in relation to relapse-free survival in univariate and multivariate analyses. Stage and interaction between [3H]thymidine labelling index and histology provided significant prognostic information for the overall series. [3H]thymidine labelling index was an independent prognostic indicator of 3 year relapse-free survival in patients with adenocarcinoma. The results indicate the importance of cell proliferation to complement prognostic information provided by pathological stage in patients with stage II-IIIa adenocarcinomas.
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Affiliation(s)
- A Costa
- Oncologia Sperimentale C, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy
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9
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Mountain CF. New prognostic factors in lung cancer. Biologic prophets of cancer cell aggression. Chest 1995; 108:246-54. [PMID: 7606966 DOI: 10.1378/chest.108.1.246] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Affiliation(s)
- C F Mountain
- Department of Thoracic and Cardiovascular Surgery, University of Texas M.D. Anderson Cancer Center, Houston, USA
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10
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Saccani Jotti GM, Gabrielli M, Orsi N, Fontanesi M, Sansebastiano G, Rusca M. Preliminary study on thymidine labelling index in human non-small cell lung cancer. Int J Biol Markers 1995; 10:122-3. [PMID: 7561239 DOI: 10.1177/172460089501000212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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11
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Morisaki Y, Shima S, Yoshizumi Y, Sugiura Y, Tanaka S, Tamai S. PCNA immunostaining combined with AgNOR staining in esophageal squamous cell carcinoma to identify patients with a poor prognosis. Surg Today 1995; 25:389-95. [PMID: 7640465 DOI: 10.1007/bf00311814] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Immunostaining of the proliferating cell nuclear antigen (PCNA) provides important information about cell kinetics and is easily performed on routinely obtained formalin-fixed, paraffin-embedded materials. We report herein the results of a retrospective study on PCNA staining in esophageal cancer undertaken to determine its significance. As this study indicated that immunoreactivity was preserved in specimens fixed within 24h, only 31 specimens from surgical patients were available for this investigation. The mean PCNA index of the patients without invasion to the adventitia (35.7 +/- 17.9) was significantly lower than that of those with invasion to the adventitia or neighboring structures (49.7 +/- 14.5), while the PCNA index did not correlate with other clinicopathologic parameters such as histologic type, lymph node metastases, or prognosis. However, when an analysis of PCNA staining was combined with an analysis of argyrophilic nucleolar organizer region (AgNOR) staining, a correlation with prognosis was found. In fact, seven patients with a high PCNA index (> or = 44) and AgNOR count (> or = 6) had a significantly poorer prognosis than the remaining 22 (P = 0.0014), and six of these seven patients died within 2 years. These results indicate that this combined evaluation may be useful for the identification of patients with a poor prognosis among those undergoing surgery for esophageal squamous cell carcinoma.
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Affiliation(s)
- Y Morisaki
- Department of Surgery II, National Defense Medical College, Saitama, Japan
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12
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13
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Ponz de Leon M. Genetic factors in lung cancer. Recent Results Cancer Res 1994; 136:146-61. [PMID: 7863093 DOI: 10.1007/978-3-642-85076-9_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- M Ponz de Leon
- Università degli Studi di Modena, Istituto di Patologia Medica, Italy
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14
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Alama A, Chiara S, Merlo F, Ragni N, Conte PF, Meazza R, Reggiardo G, Ferrari I, Rosso R. Tumour kinetics, response to chemotherapy and survival in primary ovarian cancer. Eur J Cancer 1994; 30A:449-52. [PMID: 8018401 DOI: 10.1016/0959-8049(94)90416-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The analysis of thymidine labelling index (TLI) in relation to clinico-pathological variables and survival was carried out in 111 ovarian cancer patients. The significance of TLI in predicting response to aggressive first line chemotherapy regimens was examined. The overall median TLI value of 1.8% was used as a cut-off to discriminate slowly from highly proliferating cancers. 94 patients entered into two consecutive randomised trials, and were treated with six courses of cisplatin-based chemotherapy with or without doxorubicin. A significantly higher objective response of 60% was reported in the subset of patients with TLI > 1.8% as compared to 35% in patients with TLI < or = 1.8% (P = 0.03). In addition, patients achieving complete response had tumours with median TLI of 3.8% as compared to 2.4% for partial responders, 1.5% for patients with stable disease and 1.7% for those with progressive disease. A significant increase in tumour kinetics was observed in advanced cancers (P = 0.001), more undifferentiated tumours (P = 0.02) and postsurgical residual disease greater than 2 cm (P = 0.04). In univariate analysis, TLI failed to influence significantly clinical outcome: 26 versus 32 months median survival time for patients with high and low tumour TLI, respectively. In the Cox's regression model, the only independent prognostic variables were performance status and amount of residual disease after primary surgery (P = 0.000).
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Affiliation(s)
- A Alama
- Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
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15
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Broers JL, Viallet J, Jensen SM, Pass H, Travis WD, Minna JD, Linnoila RI. Expression of c-myc in progenitor cells of the bronchopulmonary epithelium and in a large number of non-small cell lung cancers. Am J Respir Cell Mol Biol 1993; 9:33-43. [PMID: 8393325 DOI: 10.1165/ajrcmb/9.1.33] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
We performed in situ hybridization for c-myc, N-myc, and L-myc mRNA expression using 35S-labeled cRNA probes on frozen sections of 19 pairs of non-small cell lung cancers (NSCLC) and the surrounding non-neoplastic lung tissue. In non-neoplastic lung, c-myc expression was strongest in bronchial epithelium basal cells and hyperplastic alveolar type II pneumocytes, which are potential progenitor cells for bronchopulmonary epithelium and their tumors. In contrast, N-myc and L-myc mRNAs were not detected in non-neoplastic lung. In studies of freshly resected primary tumors, expression of c-myc was detected in 11 of 19 NSCLC (with the highest levels in squamous cell carcinomas), two of which also expressed L-myc, while N-myc expression was never detected. Levels of c-myc expression in tumors were significantly higher than in non-neoplastic lung samples. We conclude that: (1) c-myc expression in non-neoplastic lung tissues is highest in bronchial basal cells and hyperplastic type II cells, and (2) in NSCLC, overexpression of the myc-proto-oncogene is common.
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Affiliation(s)
- J L Broers
- Navy Medical Oncology Branch, Bethesda, Maryland
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16
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Fontanini G, Macchiarini P, Pepe S, Ruggiero A, Hardin M, Bigini D, Vignati S, Pingitore R, Angeletti CA. The expression of proliferating cell nuclear antigen in paraffin sections of peripheral, node-negative non-small cell lung cancer. Cancer 1992; 70:1520-7. [PMID: 1355398 DOI: 10.1002/1097-0142(19920915)70:6<1520::aid-cncr2820700613>3.0.co;2-k] [Citation(s) in RCA: 61] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Cell proliferation of 40 peripheral, node-negative non-small cell lung cancers (NSCLC) treated with surgery alone was investigated by immunohistochemical analysis with the monoclonal antibody (MoAb) PC10, which recognizes a proliferating cell nuclear antigen (PCNA) in formalin-fixed and paraffin-embedded material. Results were correlated with DNA ploidy and S-phase fraction (SPF) analyzed by DNA flow cytometric study. Mitotic count (MC) was analyzed by light microscopic study and histopathologic features. PCNA immunoreactivity was seen in all samples and confined to the nuclei of cancer, but not to the surrounding, tumor-negative cells; its frequency ranged from 0-70% (median, 15%), and tumors expressed either a low (0-25%, n = 25) or intermediate (26-75%, n = 15) proliferative activity. There was no relationship between PCNA immunoreactivity and tumor stage or among size, histologic type, and mitotic count (MC). Tumors with intratumoral blood vessel invasion (BVI) showed a significantly higher (P less than 0.005) PCNA immunoreactivity than BVI-negative tumors. PCNA scores were significantly higher (P less than 0.005) in DNA aneuploid (n = 22) than in DNA diploid (n = 18) tumors and correlated significantly with the SPF of DNA aneuploid tumors (r = 0.825, P less than 0.0001), but not with diploid tumors (r = 0.002, P = 0.9). Intermediate proliferating tumors had a significantly higher (P less than 0.01) MC than their counterparts. In univariate analysis, significant predictors of survival were tumor classification (T1 versus T2), tumor size (less than or equal to 2.6 cm versus more than 2.6 cm), BVI (BVI-negative versus BVI-positive), MC (less than or equal to 8 versus more than 8), and PCNA immunoreactivity (low versus intermediate). DNA ploidy and SPF did not influence survival significantly. Only PCNA immunoreactivity retained its independent level of significance (P = 0.02) by multivariate analysis. It was concluded that PCNA immunostaining is a simple and clinically useful method for estimating cell proliferation in formalin-fixed, paraffin-embedded tissue of resected peripheral, node-negative NSCLC.
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Affiliation(s)
- G Fontanini
- Institute of Pathological Anatomy and Histology, University of Pisa, Italy
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17
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Alama A, Merlo F, Chiara S, Muttini MP, Guido T, Nicolò G, Conte PF, Ragni N. Prediction of survival by thymidine labelling index in patients with resistant ovarian carcinoma. Eur J Cancer 1992; 28A:1079-80. [PMID: 1627379 DOI: 10.1016/0959-8049(92)90461-a] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The relationship between tumour proliferative activity, evaluated by thymidine labelling index (TLI), clinicopathological variables and clinical outcome, was analysed in a series of 64 chemotherapy-resistant, ovarian cancer patients. The median TLI of 4.6% (range 0.01-45.7) was used as the cut-off to discriminate rapidly from slowly proliferating tumours. Univariate analyses showed a significant advantage in survival for patients with TLI less than or equal to 4.6 (P = 0.0004), ECOG performance status less than or equal to 1 (P = 0.0001) and residual disease after primary surgery less than or equal to 2 cm (P = 0.019). Multivariate analysis demonstrated that performance status was the only independent prognostic variable, although TLI was the last covariate removed from the Cox's regression model.
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Affiliation(s)
- A Alama
- Department of Pharmacology, Istituto Nazionale per la Ricerca Sul Cancro, Genova, Italy
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