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. 2004 Oct 4;91(7):1293-300.
doi: 10.1038/sj.bjc.6602134.

Prognostic value of nonangiogenic and angiogenic growth patterns in non-small-cell lung cancer

P Sardari Nia  1 , C Colpaert, B Blyweert, B Kui, P Vermeulen, M Ferguson, J Hendriks, J Weyler, F Pezzella, E Van Marck, P Van Schil
Affiliations

Prognostic value of nonangiogenic and angiogenic growth patterns in non-small-cell lung cancer

P Sardari Nia et al. Br J Cancer. .

Abstract

An essential prerequisite of nonangiogenic growth appears to be the ability of the tumour to preserve the parenchymal structures of the host tissue. This morphological feature is visible on a routine tissue section. Based on this feature, we classified haematoxylin and eosin-stained tissue sections from 279 patients with non-small-cell lung cancer into three growth patterns: destructive (angiogenic; n=196), papillary (intermediate; n=38) and alveolar (nonangiogenic; n=45). A Cox multiple regression model was used to test the prognostic value of growth patterns together with other relevant clinicopathological factors. For overall survival, growth pattern (P=0.007), N-status (P=0.001), age (P=0.020) and type of operation (P=0.056) were independent prognostic factors. For disease-free survival, only growth pattern (P=0.007) and N-status (P<0.001) had an independent prognostic value. Alveolar (hazard ratio=1.825, 95% confidence interval=1.117-2.980, P=0.016) and papillary (hazard ratio=1.977, 95% confidence interval=1.169-3.345, P=0.011) growth patterns were independent predictors of poor prognosis. The proposed classification has an independent prognostic value for overall survival as well as for disease-free survival, providing a possible explanation for survival differences of patients in the same disease stage.

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Figures

Figure 1
Figure 1
Classification of non-small-cell lung cancer.
Figure 2
Figure 2
Growth patterns of non-small cell lung cancer are visible on routine H&E-stained tissue sections. (A) Destructive growth pattern (angiogenic): parenchymal structures of the lung are not preserved, but replaced by carcinoma cells and tumour-associated stroma. (B) Papillary growth pattern (intermediate): the lung parenchyma is preserved with formation of fibrovascular stalks originating from the alveolar septa. (C) Alveolar growth pattern (nonangiogenic): the tumour cell nests fill the alveolar spaces with preservation of alveolar septa and without formation of a tumour-associated stroma.
Figure 3
Figure 3
Disease-free survival according to growth pattern for patients in stage I (destructive vs papillary growth, P=0.0455 and destructive vs alveolar growth pattern, P=0.0465).
See this image and copyright information in PMC

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