Flow cytometry of epidermoid lung carcinomas: relationship of ploidy and cell cycle phases to survival. A five-year follow up study.

Surgical specimens of tumors of 105 patients with previously untreated epidermoid lung carcinomas were investigated by means of flow cytometry and the results compared with the survival of the patients. The aim of the present prospective study was to establish further the efficacy of cytometric analysis, independent of well known clinical factors. For determining prognosis, all patients had a minimum of 5 years follow-up. The present study clearly shows that, independent of clinical characteristics, cytometric DNA content analysis has prognostic importance in patients with epidermoid lung carcinomas. Patients with aneuploid tumors died significantly sooner than those who had tumors with DNA diploidy. Patients whose tumors had a high proliferative activity (proportion of Go/G1-phase-cells less than or equal to 78%, S-phase-cells greater than 8%, G2M-phase-cells greater than 14%) died significantly earlier than patients with tumors with lower proliferation activity. Comparisons within homogeneous groups of patients with respect to the clinical characteristics (T3, NM+, stage III, surgery, treatment) showed identical results. In addition to the univariate analyses, multivariate analyses (Cox-regression model) were used. The results of this study demonstrate two groups of independent prognostic factors for the survival of patients with epidermoid carcinomas: clinical factors and flow cytometric factors.