The Clinical Use of Quantitative Image Analysis in Lung Tumors

Article type: Research Article

Authors: Carvalho, Lina | Martins, Maria João | Seixas, Mário

Note: [] Address for correspondence: Lina Carvalho Anatomia Patológica Hospitais da Universidade de Coimbra IPATIMUP, Universidade do Porto Portugal

Abstract: A great effort has been undertaken done to determine prognostic and therapeutic markers to enhancing diagnosis and survival. These targets have been focused by the recent technological developments and knowledge in genetics, molecular biology and informatics. As tumorgenesis is associated with chromosomic alterations, these can be validated by measurable differences in DNA content analysis either by flow on static cytometry. The second method is more appreciated by pathologists and frequently applied to solid tumors. A total number of 120 lung carcinomas has been classified according to the WHO classification is 42 adenocarcinomas, 38 squamous cell carcinomas, 12 carcinoids, 9 adenosquamous carcinomas, 6 bronchioloalveolar carcinomas, 8 large cell neuroendocrine carcinomas, 3 pleomorphic carcinomas and 2 small cell combined carcinomas. They have been submitted to static cytometry for DNA quantification. The study was made by application of Feulgen´s stain to touch smears of each tumor and then validated by the digital equipment CAS 200. The DNA content analysis distinguished two levels: namely diploid and non-diploid tumors. A correlation between non-detectable lymphnode metastases and small size (<3cm) of squamous cell carcinomas was seen with diploid tumors and improved prognosis. In the group of adenocarcinomas, the large variability of DNA content hinders the utility of this variable to define the progression of the disease. Carcinoids and the other types of neuroendocrine carcinomas could be distinguished by diploidy and aneuploidy. In this way, DNA image analysis is useful for a detailed morphological evaluation, and can be used to estimate the prognosis. The use of DNA content to defining the prognosis of lung cancer patients has to be considered to be biased by the applied method and the variability of DNA content in different histological groups of lung carcinoma. In adenocarcinomas, it has been shown that a higher DNA index correlates with a higher frequency of brain metastasis. In squamous cell carcinomas, aneuploidy correlates with shorter survival.

Keywords: lung carcinomas, DNA, image analysis, ploidy

Journal: Electronic Journal of Pathology and Histology, vol. 7, no. 4, pp. 05-05, 2001