Immunity Netwoks in Prediction of Five-Year Survival of Lung Cancer Patients after Radical Procedures Oleg Kshivets, M.D., Ph.D. Department of Surgery , Siauliai Cancer Center , Lithuania The First International Chicago Symposium on Malignancies of The Chest and Head & Neck Chicago, Illinois, The USA, 1999
Purpose : Influence of immunity networks on 5-year survival (5YS) of lung cancer (LC) patients (LCP) after a radical procedure (RP) was investigated.
Methods : In randomized trial (1987-1998) cases after RP, monitored 108 LCP (males – 94, females – 14; pneumonectomy - 45, upper lobectomy - 44, lower lobectomy - 11, upper/lower bilobectomy - 5, middle lobectomy -1) with pathologic stage II-III (stage II – 34, stage III – 74; squamos cell LC - 56, adenocarcinoma - 46, large cell LC - 6; T1 - 38, T2 - 43, T3 – 23, T4 - 4; N0 – 63, N1 - 20, N2 - 25; G1 – 30, G2 – 34, G3 - 44) were reviewed. 59 LCP (age=56.7 0.9 years; tumor size: D=4.3 0.3 cm; life span: LS=1903.8 21.0 days) lived more than 5 years without any features of LC progressing. 49 LCP (age=56.6 1.2 years; D=4.6 0.3 cm; LS=542.7 55.2 days) died because of generalization of LC during the first 5 years after RP. Variables selected for 5YS study were input levels of 49 immunity blood parameters, sex, age, TNMG, cell type, D. Representativeness of samplings was reached by means of randomization based on unrepeated random selection. Multiple correspondence analysis (A), multi-factor clustering, A of variance, confirmatory factor A, structural equation modeling and Monte Carlo simulation were used to determine any significant overall regularity.
Results : It was revealed that 5YS of LCP (n=108) after RP significantly depended on: 1) level of T-, B- and O-cell circuit; 2) value of monocyte- and macrophage-circuit; 3) level of humoral immunity; 4) ratio of malignant cell population quantity to immunity cell subpopulations in integral patient’s organism (cell ratio factors); 5) LC characteris-tics. Structural equation modeling and Monte Carlo simulation confirmed signifi-cant overall networks bet-ween 5YS (life span) of LCP after RP and cell immunity circuit ( 2=7744.820;k=628; T=2.264;P=0.024), humoral immunity data ( 2=20.328; k=13; T=3.496; P=0.0005), cell ratio factors ( 2=446.462; k=65; T=13.258; P=0.0001e-9), LC characteristics ( 2=69.514; k=19; T=4.520; P=0.00062e-2).