A Study of the Pattern of Recurrence Using Flow Cytometric DNA Analysis and PCNA/AgNOR Sequential Staining in Non-Small Cell Lung Cancer

Summary: Flow cytometric DNA analysis and PCNA/AgNOR sequential staining were performed to examine the pattern of recurrence in non-small cell lung cancer. The DNA ploidy was aneuploidy in 80.6% and diploidy in 19.4%. The mean DNA index (DI) was 1.63 for the total population, 1.62 in non-recurrent cases, and 1.64 in recurrent cases. The differences were not statistically significant, but the distribution pattern of DIs was somewhat at odds between non-recurrent cases and recurrent cases. In the analysis of recurrence in Stage I and II, the lung metastasises or the local recurrences were concentrated in the lower DI range, and the brain or the bone metastasises in the higher DI range. Thus, cases with DIs under 1.3 showed the lung metastasises or the local recurrences, and those over 1.9 were in the brain or the bone, but the cases with DI from 1.3 to 1.9 had all types of recurrences. The AgNOR scores obtained by sequential staining with PCNA provided more accurate information on recurrences. The cases with any DI and lower AgNOR scores (under about 3.0) in PCNA-negative cells showed rare recurrences. In the DI range of 1.3 to 1.9, many cases with AgNOR scores from 3.0 to 4.1 in PCNA-negative cells had the lung metastasises or the local recurrences, and those with AgNOR scores over 4.1 had those in the brain or the bone. The above information is considered valuable for the follow-up and postoperative management of Stage I and II non-small cell lung carcinoma