Prognostic Significance of Flow Cytometric Nuclear DNA Content and S-phase Fraction in Non-small Cell Lung Cancer / 대한내과학회지

OBJECTIVES: In surgically treated non-small cell lung cancer, patients have a wide difference in prognosis even though they may be in the same stage. Therefore it is difficult to establish the prognosis for individual lung cancer patients. In this study, by using flow cytometric analysis of nuclear DNA content and S-phase fraction(SPF) of surgically treated non-small cell lung cancer patients, we proposed to establish other prognostic factors and their validity in comparison with the existing ones. METHODS: Paraffin-embedded tissue specimens from 81 surgically treated patients, diagnosed with non-small cell lung cancer ranging from stage I to stage IIIa, were analyzed by flow cytometrically determined nulear DNA content and S-phase fraction. Cellular DNA content stained with propidium iodide was analyzed by flow cytometry: histograms with a coefficient of variation exceeding 8% were not used. RESULTS: 1) DNA content analysis was carried out for 59 of 81 patients. Of the 59 patients who were investigated by flow cytometry, 45 (76.3%) of the tumors were DNA aneuploidy and 14 (23.7%) were DNA diploidy. The proportion of DNA aneuploidy tumors showed no significant difference between cell types or stage. 2) S-phase fraction was evaluated for 36 of 81 patients. Mean value of SPF was 19.2% (+/-12.62)%. The value of SPF had nothing to do with stage. 3) The proportion of the high SPF group (more than 10% of cell proliferation cycle) was 75% With advance staging, the proportion of the high SPF group increased. 4) Significant difference in the median survival time was observed between the low SPF group and the high SPF group (32 months in low SPF, 12 months in high SPF) (p<0.05). No significant difference in the median survival time was observed between the aneuploidy group and the diploidy group (19 months in aneuploidy, 34 months in diploidy). 5) Significant difference in the disease free median survival time was observed between the low SPF group and the high SPF group (5 months in low SPF, 19 months in high SPF) (p<0.05). No significant difference in the disease free median survival time was observed between the aneuploidy group and the diploidy group (12 months in aneuploidy, 34 months in diploidy). 6) Upon multivariate analysis, stage and high SPF (more than 10% of cell proliferation cycle) were significant prognostic factors in surgically treated non-small cell lung cancer patients. CONCLUSION: The TNM stage and high SPF were significant as prognostic factors in surgically treated non-small cell lung cancer patients. Therefore new treatment plan should be needed in the patients who have high SPF.

Induced Sputum Study Via Inhalation of Hyperosmolar Saline to Investigate Airway Inflammation in Asthma: Method of Induced Sputum Study and Examination of Inflammatory Cells / 대한내과학회지

OBJECTIVES: From asymptomatic asthmatic patients unable to produce sputum spontaneously, we performed a non-invasive method obtaining sputum via inhalation of ultrsonically nebulised hyperosmolar saline(3%) which provides a way to investigate airway inflammation, And we also evaluated the effectiveness of the ultrasonic nebulizer in these patients. METHODS: 50 asymptomatic patients unable to produce sputum spontaneously inhaled a hyperosmolar saline via an Ultrasonic nebulizer to induce sputum. We examined the quality of the sputum, total cell counts and differential cell counts of eosinophil after sputum processing. RESULTS: 1) The quality of the sputum was uninterpretable (12%); poor(16%); fair(34%); good(38%), repectively. The mean induction time of expectoration was about 10 minutes. 2) The most common complaint was of a salty taste(45 cases). The mean fa11 in peak expiratory flow rate during inhalation of saline was 4.0% and the fall more than 20% was observed in 5 cases. 3) The mean eosinophil percent in induced sputum was 38.5%, The mean value of the total IgE and total peripheral eosinophil count was 818.2 IU/ml, 401.2/mm3 respectively, 4) There were no relationships between the sputum eosinophil count(%) and both the total IgE and the PC20(r=0.13, r=0.18). There was also an insignificant correlation between the sputum eosinophil count(%) and the total peripheral eosinophil count(r=D.22). CONCLUSION: We find that there are many eosinophils within induced sputum via inhalation of ultrsonically nebu1ised hyperosmolar saline from asymptomatic asthmatic patients unable to produce sputum spontaneously, Therefore we suggest that an induced sputum study via inhalation of hyperosmolar saline is useful to determine a patient`s status of airway inflammation.