340

radiographs of 13 patients. The doubling time ranged from 80 to 760 days. There was a high inverse correlation between the AgNOR count and the doubling time (r = - 0.910; P < 0.001). Conclusions. Thus, it appears to be possible to use the mean number of AgNOR as an index of proliferative activity.

Detection of a novel markes in the bronchial secretions of patients with non-small cell lung cancer wing the 4B5 monodonal antibody Deutsch MA, Pence JC, Kerns B-JM, Plate CA, Kinney R, Gooch G et al. Duke University Medical Center, Box 3056. Durham. NC 27710. Cancer 1992;69: 2894-2904

A murine monoclonal antibody designated 4B5 was raised against the high molecular weight fraction of pooled sputum from patients with non-small cell hmg cancer (NSCLC). Immunohistochemical staining indicated that 4B5 binds to histologically normal bronchial epithelium distant from tumor in 72% (39 of 54) of patients with NSCLC, but it bids to the primary cancer in only 13 96 (7 of 54) of the same patients. The antibody reacted less intensely with the bronchial epithelium in 16.6% (3 of 18) of autopsied patients without significant lung disease. The antigen recognized by 4B5 is a high molecular weight glycoprotein of more than 400 kilodaltons, judged by gel filtration and sodium dodccyl sulfate-polyacrylamide gel electrophoresis and western blot analysis. Antigenic activity persisted after heating and resisted treatment with neuraminidase, but it was destroyed using protease and periodate. Multiple epitopes were present on each molecule recognized by 4B5. The determinants recognized by this antibody deserve additional study as possible markers of premalignant change in patients with NSCLC.

Prognosticsignificanceofhistopathologicsubtypeandstageinsmall cell lung cancer Fraire AE, JohnsonEH,YesnerR, ZhangXB,SpjutHJ, GreenbergSD. DeparrmentojPathology, UniversiryojM~sachuetts, Medical Center, 55 Lake Ave N, Worcester, MA 01655. Hum Pathol 1992;23:520-8.

A study of 149 light microscopic tissue slides from 147 patients with recorded initial diagnoses of small cell lung cancer (SCLC) (114 cases) and undifferentiated carcinoma (35 cases) was undertaken to test the reproducibility and prognostic impact of a new histopathologic subclassification of SCLC proposed by the Pathology Panel of the International Association for the Study of Lung Cancer (IASLC). This study was further designed to test the impact of clinical stage, age, sex, and race on survival. The tissue slides were blindly reclassified as SCLC or non-SCLC by a panel of five pathologists with no knowledge of the initial diagnosis. The SCLCs were divided into the three subtypes outlined by the IASLC pathology panel: small (classic or pure), mixed (small cell/largecell), and combined (small cell/squamous carcinoma or small cellladenocarcinoma). Smallcell lung cancer wasclinically staged as local, regional, or distant. Consensus diagnosis (defined as agreement by at least three of the five pathologists) was achieved in 144 (96.6%) of the 149 cases. Of these 144cases. 124 were reclassified as SCLC (115 [92.8%] small, five [4.0%] mixed, and four [3.2%] combined) and 20 were classified as non-SCLC. The median lengths of survival for the small, mixed, and combined subtypes were 225, 1,110, and 203 days, respectively (P = ,025). Adequate staging data were available in 123 of the 124 SCLC cases. Of tbe 123 SCLC cases, 27 (21.9%) were local, 22 (17.9%) were regional, and 74 (60.2%) were distant stage. The median lengths of survival for the local, regional, and distant stages were 428.25 1, and 111 days, respectively. This association was highly significant (P = .COOl). We conclude that stage is the major determinant of survival in SCLC. Mixed subtypes had significantly longer survival times than the small or combined subtypes (P = ,025). Survival times were longer for women than for men, and the survival time difference between men and women was significant (P = .0028). We found no significant differences in survival according to age or race.

Clinical assessment

Postoperative increase in soluble interlwkin-2 receptor serum levels as predictor for early recurrence in non-small cell lung carcinoma Tisi E, Lissoni P, Aogeli M, Arrigoni C, Como E, Cassina E et al. Divisione di Chirurgia Toracica, Ospedak San Geardo, 20052 Monza, Milan. Cancer 1992;69:2458-62.

It is known that interleukin-2 (IL-2) plays an important role in the activation of host antitumor immune response. In addition to IL-2 cell surface receptor, a soluble form of IL-2 receptor (SIL-2R) may be released in the blopd and potentially be involved in the regulation of IL- 2 availability. High SIL-2R levels have been found in patients with lung cancer. The current study evaluated the influence of changes in SIL-2R serum levels during the periopcrative period on early relapse rate in patients with operable non- small cell lung cancer. The study included 60 patients (epidermoid carcinoma, 33; adenocarcinoma, 27). Serum levels of SIL-2R were measured with an enzyme immunoassay before surgery and 7 and 30 days after surgery. A surgery-induced increase in SIL-2R levels was seen 7 days after surgery in 38 of 60 patients. On the 30th day after surgery, SIL-2R values were lower than the preoperative values in 32 patients (Group A) or still greater in the other 28 patients (Group B). After a median follow-up of 10 months, relapse occurred in 19 of 60 patients. The relapse rate was significantly higher in Group B than in Group A patients (16 of 28 versus 3 of 32, respectively; P < 0.001). This differencealso was significant in relation to histotype and node status. This study shows that the persistence of increased SIL4R levels in the postoperative period is associated with a higher early relapse rate in patients with operable non-small cell lung cancer. The impact of SIL-2R levels on relapse suggests that host immune defenses may influence theclinical course ofpatients with lung cancer. Therefore, theevaluationofSIL-2Rin theperioperativeperiodmayrepresentanew prognostic biologic factor in operable non-small cell lung cancer.

Serum laminin PI in small cell lung cancer: A valuable indicator of distant metastasis? Nskano T, Iwahashi N, Maeda J, Hada T, Higashino K. 7&d Dept. Irtternal Med., Hyogo College of Medicine, l-l Mukogawn-rho, Nishinomivn, Hyogo 663. Br J Cancer 1992;65:608-12.

Serum laminin Pl was studied in patients with small cell lung cancer (SCLC), non-small cell lung cancer (NSCLC) respiratory infections, pulmonary tibrosis, and in normal subjects. The level of serum laminin Pl was elevated (> 1.27 U ml’) in 58.9% of SCLC and in 11.5% of NSCLC patients. Median value in SCLC was significantly higher than that in NSCLC (P<O.Ol) respiratory infection (P<O.Ol), and in normal subjects (P<O.Ol), but not statistically different from that in pulmonary fibrosis. The levels of serum laminin Pl in SCLC were related to therapeutic response. However, no certain correlation was established between the level of laminin Pl and the clinical stage of SCLC.

Bronchoalveolar lavage in lung cancer Semenrato G, Poletti V. 1st di Med Clia dell Univdi P, Clinica Medico I, Vin Guistininni 2, I-35128Padova. Respiration 1992;59:Suppl l:44- 6.

The analysis of soluble and cellular components of bronchoalveolar lavage (BAL) fluids might help the diagnosis of a specific tumour. Up to now disease specific humoral constituents have not yet been found. Concerning cellular recovery, BAL can be useful particularly in patients with bronchiole-alveolar carcinoma. The overall diagnostic yield in the case series presently available in the literature ranges from 35 to 69%. We evaluated the usefulness of BAL in the diagnosis of diffuse neoplastic lung lesions. The BAL provided a diagnostic yield in 75.9%