TNM stage, immunohistology, syntactic structure analysis and survival in patients with small cell anaplastic carcinoma of the lung.

TNM stage, immunostaining with various monoclonal and polyclonal antibodies, analysis of distance of neighboring cells, remission rates, and survival were analyzed in 60 patients suffering from small cell anaplastic carcinoma of the lung. The majority of patients showed advanced tumors at the time of admission to hospital (T2, T3 stage). Distant metastases prior to chemotherapy were detected in 34 patients. Partial remissions lasting 2-4 months were observed in 38 patients, and complete remission was documented in 7 patients. The remission rate was independent of cell type but dependent on the stage of the tumor. Some 30 patients showed positive staining with an antibody recognizing epitopes detectable on carcinoembryonic antigen, whereas 60% of the tumors were positive to a polyclonal neuron-specific enolase antibody. Tissue polypeptide antigen was found to stain positively in 5 cases only. Some 14 patients with negative staining against the monoclonal antibody BMA 406/14 showed prolonged survival compared to patients with positive staining (P less than 0.05). Patients suffering from tumors with smaller distances between neighboring cells had worse prognoses compared to patients with larger distances (P less than 0.01). Survival of patients was found to be indistinguishable if cohorts were grouped according to T stage, N stage, or existence of distant metastases. Ten patients who underwent surgical treatment of tumors did not show prolonged survival compared to 50 patients treated by combined chemotherapy only.