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Eur J Cardiothorac Surg 2005;27:1106-1111
© 2005 Elsevier Science NL

Prognostic significance of microvascularization in cases of operated lung cancer

^a Department of Surgery, University of Szeged, Pécsi u.4., H-6720 Szeged, Hungary
^b Institute of Pathology, Charite, Humboldt University, Berlin, Germany
^c Institute of Pathology, University of Szeged, Szeged, Hungary
^d Department of Medical Informatics, University of Szeged, Szeged, Hungary

Received 7 November 2004; received in revised form 15 January 2005; accepted 20 January 2005.

^* Corresponding author. Tel./fax: +36 62 54 57 01. (E-mail: szoketama{at}hotmail.com).

Objective: Measurement of microvascularization and determination of its prognostic significance in cases of lung cancer. Methods: Section prepared from histological material from 432 radically operated non-small cell lung cancer patients were stained with antibodies against factor VIII-associated antigen. During computer imaging, the absolute and relative parameters of the vascularization were determined, as was the density of tumour cells situated in the vicinity of the vessels. The results were compared with the TNM status, the cell type and the survival. Results: Each parameter demonstrated an enhanced vascularization in classifications T2 and T4, but only the surface fraction, the mean vascular circumference and the mean vascular area displayed a significant change. The microvascularization parameters did not differ significantly between with different N status, however, the cell density progressively increased in the areas close to the vessels in advanced pN classifications. Elevation of the tumour cell density within 20µm distance of the vessels was accompanied by a significantly poorer survival rate. The density of tumour cells within 20µm region was the second strongest prognostic factor after the N status. Conclusions: More advanced tumour classifications grow with enhanced vascularization. A clear-cut connection cannot be demonstrated between the vascularization and appearance of lymph node metastases. The density of tumour cells measured in the direct vicinity of vessels is an important prognostic factor.

Key Words: Lung cancer • Angiogenesis • Survival • Syntactic structure analysis