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Purpose:To investigate the features of midkine( MK) protein expression and the correlation between MK expression with angiogenes is and prognosis in non-small-cell lung cancer(NSCLC). Methods:Immunohistochemistry analysis for MK and microvessel de nsity(MVD) were performed on 44 samples of tumor tissue. Results:No positivity expression was detected in either the lun g tissue close to tumor or normal lung tissue,but 26 of 44 NSCLC tissue showed a positive reaction to MK immunostain. Significant correlation between MK express ion with MVD enhancement and lymph metastasis in NSCLC was found,and the surviva l terms in NSCLC with MK expression were significantly shorter than those in NSC LC without MK expression.The enhanced MVD was related to lymph metastasis signif icantly,and the survival terms in NSCLC with enhanced MVD were significantly sho rter than those in NSCLC without enhancement. Conclusions:In human non-small-cell lung cancer, MK overexpre ssion at the protein level may very well be closely related to angiogenesis and metastasis. MK protein may be one of the predictors for prognosis in NSCLC.
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Objective To evaluate the efficacy of post-operative radiotherapy and prognosis of renal cell carcinoma(RCC). Methods Between 1981 and 1998 , 90 s uch patients with disease limited to the kidney underwent nephrectomy at our ins titution. According to TNM classification(UICC,1997) the pathological stage was: Ⅰin 27 patients(30%),Ⅱ in 18 (20%), Ⅲ in 35(38.9%), and Ⅳ in 10(11.1%).Post - operative irradiation, with a median dose of 50?Gy in 25 fractions over 5 weeks w as given to 52 patients in 3～5weeks after surgery, using AP-PA opposing portal s or oblique portals. Results The 5- and 10-year survival rates in the irradiate d patients(S+Rt) were 75% and 60%,respectively, but in the non-irradiated patien t s(S) 50% and 40%, respectively.This difference is statistically significant. 5- y ear survival rates by TNM stage in the two groups were as follows: stageⅠ:S 67 %,S+Rt 100%;stageⅡ: S 55%,S+Rt 71%;stageⅢ: S 47%,S+Rt 65% (P=0 .010);stageⅣ: S 0%, S+Rt 43%.Diseases recurred locally in a total of 12 patients: 3 had tumo r b ed recurrence and 6 had regional lymph node recurrence and 3 had both. Local rec urrence in S was 29% and that of S+R was 2% (P=0.001). and local recurrence by T NM stage:Ⅲ were 33% and 5%, respectively. One patient developed radiation-indu c ed small bowel obstruction which necessitated surgical intervention, but no pat i ent died from radiotherapy-induced complications. By multivariate analysis: per f ormance status, symptomatic presentation, lymph node involvement, post-operativ e radiation and post-operative residual were all independent predictors of overa l l survival in the RCC patients. Conclusions In renal cell carcinoma, radiothera py is beneficial in reducing the locoregional recurrence. Radiotherapy has a sup prisingly positive effect on both local control and survival in TNM stage Ⅲ pat ients. Performance status, symptomatic presentation, lymph node involvement, pos t-operative radiation and post-operative residual are prognostic indicators of RCC. TNM staging is superior to Robson staging in predictive values .