Prognostic value of cytokinetic parameters in lung cancer after in vivo bromodeoxyuridine labelling.

ABSTRACT

BACKGROUND: To improve the overall survival rate in lung cancer by adjustment of treatment protocols on basis of tumour characteristics of individual patients, independent predictive parameters are required. Therefore, we evaluated the prognostic value of cytokinetic parameters such as bromodeoxyuridine (BrdU) labelling index (LI), S-phase fraction (SPF), unlabelled S-phase fraction (USPF), S-phase duration (Ts) and potential tumour doubling time (Tpot), next to more established parameters. MATERIALS AND METHODS: To this end a series of 92 bronchoscopic specimens of in vivo BrdU labelled lung cancer patients, 72 presenting with non-small cell lung carcinoma (NSCLC) and 20 patients with small cell lung carcinoma (SCLC), were analysed flow cytometrically. Clinical as well as cytokinetic data were collected and related to survival times over a follow-up period of 2 to 7 years. RESULTS: We found that Tpot was a significant independent discriminator of good and poor prognosis in NSCLC. In particular, in non-squamous NSCLC a short Tpot, short Ts and high LI predicted for shorter survival time. In squamous cell carcinoma, a high USPF may predict a shorter survival period, although the correlation was only borderline-significant. CONCLUSIONS: We conclude that these parameters may in future be of use in drawing up more adequate treatment schedules for individual lung cancer patients.