The expression of vascular endothelial growth factor was one of the most important prognostic factors in completely resected non-small-cell lung cancer, especially in squamous cell carcinoma.

RESULTS. Thirty-one of 115 NSCLC specimens (27%) showed negative p16 staining. Department of Surgery II, School of Medicine,The frequency of negative p16 expression was significantly higher in squamous University of Occupational and Environmental cell carcinoma (39.5%) than in adenocarcinoma (20.3%) (P Å 0.026). There were Health, Kitakyushu, Japan.no statistically significant differences in the p16 status with respect to age, gender, smoking history, histologic differentiation, or stage of the disease. The KaplanMeier survival curves demonstrated that patients with negative p16 expression survived for a significantly shorter period of time than those with positive p16 expression (P Å 0.043). p16 status was a significant prognostic factor, especially in patients with early stage disease (Stages I-II) (P Å 0.039). CONCLUSIONS.A lack of p16 INK4 expression in NSCLC was observed more frequently in squamous cell carcinoma than in adenocarcinoma, and also was found to be closely related to prognosis, especially in patients with early stage squamous cell carcinoma.

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Background-Although the preoperative prediction of pulmonary complications after lung major surgery has been reported in various papers, it still remains unclear. Methods-Eighty nine patients with stage I-IIIA non-small cell lung cancer (NSCLC) who underwent a complete resection at our institute from 1994-8 were evaluated for the feasibility of making a preoperative prediction of pulmonary complications. All had either a predicted postoperative forced vital capacity (FVC) of >800 ml/m 2 or forced expiratory volume in one second (FEV 1 ) of >600 ml/m 2 . Results-Postoperative complications occurred in 37 patients (41.2%) but no patients died during the 30 day period after the operation. Pulmonary complications occurred in 20 patients (22.5%). Univariate analysis indicated that the factors significantly related to pulmonary complications were FVC <80%, serum lactate dehydrogenase (LDH) level >230 U/l, and arterial oxygen tension (PaO 2 ) <10.6 kPa (80 mm Hg). In a multivariate analysis the three independent predictors of pulmonary complications were serum LDH >230 U/l (odds ratio (OR) 10.5, 95% CI 1.4 to 77.3), residual volume (RV)/total lung capacity (TLC) >30% (OR 6.0, 95% CI 1.1 to 33.7), and PaO 2 <10.6 kPa (OR 5.6, 95% CI 1.4 to 22.2). Conclusions-The above findings indicate that three factors (serum LDH levels of >230 U/l, RV/TLC >30%, and PaO 2 <10.6 kPa) may be associated with pulmonary complications in patients undergoing a lobectomy for NSCLC, even though the patient group was relatively small for statistical analysis of such a diverse subject as pulmonary complications. (Thorax 2001;56:59-61) Keywords: non-small cell lung cancer; pulmonary complications; morbidity Lung cancer is the leading cause of death among cancer patients. 1 The necessity for surgical treatment is increasing because complete surgical removal of a tumour oVers the best chance for a cure in patients with non-small cell lung cancer (NSCLC). 2 3 A lobectomy remains the standard therapeutic option in most patients with early stage NSCLC. Although the operative mortality and morbidity following a lobectomy has decreased over the past decade, both factors still contribute significantly to the cost of treating such patients. Careful selection of the operative modalities is therefore required to reduce the overall mortality and morbidity.Clinicians are often faced with the problem of morbidity, especially pulmonary complications, which tend to be impossible to predict. Pulmonary complications after lung resection can have serious consequences because the remaining lung tissue is severely compromised during the immediate postoperative period. In the present study we have reviewed a series of patients with NSCLC to evaluate the feasibility of preoperatively predicting pulmonary complications. Methods PATIENTSFrom April 1994 to December 1998, 299 patients with primary lung cancer underwent lung resection at the Department of Surgery II, University of Occupational and Environmental Health, Kitakyushu, Japan. Of these, 89 patients wit...