Angiogenesis and mast cell density in invasive pulmonary adenocarcinoma.

INTRODUCTION: Angiogenesis and mast cells affect the behavior of pulmonary adenocarcinoma. Measuring the angiogenesis and mast cell density (MCD) and their effect on survival of the patients may be helpful to guide the use of cancer chemotherapeutic agents which target tumor angiogenesis and mast cells.
MATERIALS AND METHODS: It was a descriptive study, conducted at Gulab Devi Chest Hospital and University of Health Sciences Lahore. It included 23 newly diagnosed, adult patients of invasive pulmonary adenocarcinoma. Clinical history was obtained and biopsy specimen was processed. Angiogenesis was determined by immunohistochemical staining with CD34. Mast cells were counted in toluidine blue stained sections. Patients were followed-up till death.
RESULTS: Mean age of the patients was 54.83 ± 2.799 years. Majority (60.9%) were males. Only 39.1% patients were smokers. Morphologically, large proportions of tumors (73.9%) were nonmucinous and moderately or poorly differentiated. Majority (69.6%) of patients presented at advanced stage (Tumor-Node-Metastasis staging (TNM )III and IV). Mean microvascular density (MVD) was 13.04 ± 1.12 and mean MCD was 3.26 ± 0.36 per high power field (HPF). High MVD was associated with poor differentiation and advanced stage and correlated with poor survival (P = 0.0001). High MCD was associated with high grade but not with the advance stage of disease. However, high MCD correlated with poor survival (P = 0.047). Moreover, MCD was positively correlated with angiogenesis (r = 0.727, P = 0.0001). Treatment did not affect the survival significantly (P = 0.069).
CONCLUSION: High angiogenesis and MCD predict poor survival and are positively correlated with each other and with the histological grades in pulmonary adenocarcinoma. High angiogenesis is also associated with advance TNM stage of disease.