69

cell carcinomas and 0/20 squamous cell

carcinomas. We conclude: i) most, but not all, SCLC

and carcinoids express multiple NE markers in a high percentage of tumor cells; 2) occasional (4%) of non small cell lung cancers show staining patterns indistin- guishable from SCLC; 3) many non small cell lung cancers contain a small subpopulation of cells expressing NE markers. These re- sults provide further evidence for a com- mon origin for all lung cancers.

Characteristics of Long-Term Survivors After Treatment for Inoperable Carcinoma of the Lung. Komaki, R., Cox, J.D., Hartz, A.J., By- hardt, R.W., Perez-Tamayo, C., Clowry, L. Department of Radiation Oncology, The Medical College of Wisconsin Affiliated Hos- pitals, Milwaukee, Wisconsin 53226.

Between January, 1971 and August, 1978, 410 patients with histologically or cytolo- gically confirmed inoperable or unresectab- le carcinoma of the lung were treated with curative intent. Forty-five patients lived a minimum of 3 years and 32 patients lived 5 or more years. The 3-year survival rate increased from 7.6% (15/197) between 1971 and June, 1975 to 14.1% (30/213) for the interval from July, 1975 to August, 1978 (p < .01). Factors associated with long- term survival were performance status (p < .01), early stage (p < .001), high total dose of radiations (p < .02), large cell carcinoma (p < .01), inoperable for medical reasons (p < .001), and thoraco- tomy to determine unresectability (p < .04). The difference in survival rates between the two time periods was not related to diffe- rent patient factors. Survival rates were most improved in the second t£me period for patients with stage II or stage III car- cinoma of the lung. Eight patients died from cancer between 36 and 54 months of initial treatment. Five patients died of intercurrent disease without evidence of cancer of the lung after 3 years. An in- creasing proportion of long-term survi- vors of inoperable carcinoma of the lung can be expected to result from a better understanding of these diseases, more tech- nically sophisticated external irradiation, and the use of combination chemotherapy for small cell carcinoma.

Lymph Node Reactivity of Stage I, II Lung Cancer-P[ognosis and Background Factors. Naka~ura , K., Naka~oto , K., Maeda , M., Mori , T., Sawamura , K. i. Department of Surgery, Kagawa Medical School, 2. National Kinki Central Hospital for Chest Diseases.

We set up a score system composed of histological appearance of mediastinal

lymph nodes. One point is to be given on posi- tive sinus histiocytosis, positive paracortical

hyperplasia, negative follicular hyperplasia, and negative hyaline nodules respectively.

Eighty seven patients with pathological stage I, II lung cancer (34 adeno-, 53 epider- mold carcinoma) received surgical resection in Natl. Kinki Central Hospital for Chest Disea- ses during the period since 1975 through 1979. They were classified according to the score,ie group A with 4 points, group B with 3, group C with 2, and group D with one point. Number of cases in each group were ii, 29, 32, 15 respectively.

As the result, five year survivals were 100% in group A, 81% in group B, 33% in group C, and 44% in group D. Significant difference was noted between group A and group C, D, and between group B and group C,D (p < 0.01). As for the backgrounds the score has significant correlation with peripheral blood lymphocyte count (2600 + 610, 2210 ~ 610, 1290 + 990 (p < 0.05)).--Age, DNCB skin test has--correla- tion but not significant (p = 0.14). NO corre- lation wa~ found with sex, pN factor, nor PPD skin test reactivity.

l,m~unocompetence in Lung Cancer. Pierri, I., Rogna, S., Tavano, A., Poggi, A., Ratto, G., Motta, G., Indiveri, F. I.S.M.I. Immunologia Clinica e Semeiotica Chirurgica - Universit~ degli Studi di Genova, Italy.

The aim of this study is to analyze the im- mune competence of patients with lung cancer. To this end we have evaluated (a) the serum le- vel of Ig, complement, circulating immune com- plex and (b) the phenotype and function (s) of lymphocytes in 42 patients with lung cancer.

The data about sera did not show any signi- ficant information with respect to the type and the clinical stage of the disease. The study of lymphocytes has been performed with cells from the peripheral blood and from lymph nodes re- gional of the cancer with a panel of monoclo- nal antibodies (EKTI- TII - T3 - T4 - T8 and Q 5/13, Q 5/06) in an indirect rosette micro- assay and by evaluating their responsiveness upon mitogen, alloantigens and autoandigens activation in vitro.

Lymphocytes from lymph nodes did not show significant phenotypic differences with re- spect to those isolated from peripheral blood. Lymphocytes from lymph nodes as well as PBL underwent blastogenesis upon activation by mi- togens and antigens in vitro. Nevertheless the extent of such activation resulted different with respect to the source of responding and/or stimulator cells.

The present study suggests that the analysis of lymphocytes isolated from lymph nodes re- gional of human malignant tumours may help to understand the host-tumour relationship.

I.mune Reactivity to Thomsen-Friedenreich Anti-

gen in Patients with Lung Cnacer Detected by

70

Superoxide Assay-Leukocyte Adherence Inhi- bition Test. Ichinose, Y., Yagawa, K., Hara, N., Nogep

S., Motohiro, A., Ishimatsu, T., Ohta, M. National Kyushu Cancer Center, Fukuoka,

Japan. The immune reactivity to partially pu-

rified Thomsen-Friedenreich (T) antigen was investigated in patients with lung cancer. The modified method of original leukocyte adherence inhibition test, ter- med superoxide assay-leukocyte adherence inhibition test, was used to detect the reactivity. The peripheral mononuclear cells from 32 out of 44 (73%) patients

with lung cancer showed a positive re- sponse to the antigen, whereas in only 3 of 18 patients (17%) with benign pulmona- ry disease was there a reaction to the &ntigen. The same experiments were perform- ed using the 3M KCI extract of the lung tumors as an antigen. In this. case, 37 of 44 (84%) patients with lung cancer, but only 4 of 23 (17%) with benign pulmonary disease and in none of the breast cancer patients (0/17) was there a reaction to the antigen.

These results strongly suggest that patients with lung cancer are sensitized to both T antigen and tumor associated an- tigens in cancer cells of lung tissue ori- gin.

LAX Reactivity o f Mononuclear Cells from Patients wlth Lun@ Cancer of Different Sta@es

No. o f Positive I ~ I ~} Stage patients T Tumoz extract B o t h

i , i i 16 13 (81 ) 15 (94) 12 (75) i i i (ope) I I I f I V 28 19 (68 ) 22 (79 ) 13 (46) T o t a l 44 32 (73) 37 (84 ) 25 (57)

Pulmonary Adenocarcinoma Antigen Detected in Pleural Effusions by Monoclonal Antibody. Kouno, N., Nohmi, K., Yamakido, M..Hiroshi- ma University School of Medicine, Hiroshima, Japan. Kyoizumi, S., Kobuke, A., Hakoda, M., Akiyama, M. Radiation Effects Research Foundation, Hiroshima, Japan.

A monoclonal antibody was produced by fusing murine myeloma NS 1 cells with sple- nocytes from a BALB/c mouse immunized with human pulmonary adenocarcinoma VMRC-LCR cells. Immunohistochemical analysis of frozen tissue sections showed that this mo- noclonal antibody reacts with pulmonary adenocarcinomas, pulmonary small cell car- cinomas and certain cells of normal bron- chioles, but not with pulmonary squamous cell carcinomas.

A solid-phase enzyme immunosorbent sand- wich assay for detecting soluble antigen in pleural effusions was established. The antigen levels in pleural effusions were higher in cases of pulmonary adenocarci- noma than those of pulmonary squamous cell carcinoma and tuberculosis.

Prognostic Factors in Long Term Survivors

of Small Cell Lung Cancer (S.C.L.C.) Clingan, P.R., Jamrozik, K., Byrne, M.J. Department of

Medical Oncology, Sir Charles Gairdner Hospital & Unit of Clinical Epidemiology, University of Western Australia.

165 patients (pts) with S.C.L.C. were seen at S.C.G.H. between Sept. 1975 and July 1982. 60 pts all ECOG performance status < 2 and age < 70 yrs had limited disease, i~ of whom were long term survivors (L.T.S.) > 24 mths. There were no L.T.S. from extensive disease. From Sept. 1975 - Dec. 1980, 40 limited d~s- ease pts were treated with ~yclo 400 mg/m-o- rally day i~5, VCR 1.4 mg/m- i.v. day I, and MTX 30 mg/m i.v. day 22 (CVM) monthly for 18 mths. 6 of these pts were L.T.S. 3M: 3F range 27-84+ mths. From Dec. 1980 - July 1982 20 pts with limited disease were treated with c~s- platinum 60 mg/m 2 i.v. day i, VP-16 120 mg/m i.v. day i, 3, 5, 3 weekly alternating with CVM 4 weekly for 3 cycles. 6 of these 4M: 2F pts were L.T.S. range 25-37+ mths. Prior to Dec. 1980 radiation was variable; after this time pts received 50 Gy to 1 ° with prophylactic cra- nial radiation for complete responders. Compa- ring all the L.T.S. with all the short term survivors (S.T.S.) with limited diseaee, there was no difference in sex ratio or age (57 vs 59). In 22/60 limited pts tumour size and halving time (t/2) were assessed from serial chest x- rays. L.T.S. had smaller tumours median 33 vs i00 cc (p = .01). There was no significant dif- ference in t/2 between cycles or treatments. 9 of the limited patients with peripheral 1 O had improved median survival 20 mths vs 15 mths (pc .O4) .

In conclusion, it seems that limited dis- ease pts who have 1 ° tumours with a peripheral location, and those with small 1 ° tumours have improved L.T.S.

Patterns of Failure in Oat Cell Carcinoma of the Lung in Patients Primarily Treated by Chemo- therapy. A Retrospective Review. Moinuddin Ali, M., Hazra, T.A. Medical College of Virginia/Virginia Commonwealth University, Department of Radiology, Division of Radiation Therapy & Oncology, Richmond, Virginia 23298.

Between January, 1976 to July, 1981, 75 patients with small cell carcinoma of the lung were treated at the Medical College of Virginia and its affiliated hospitals. These patients, were grouped, (i) localized disease (i0 pati- ents); (2) considered localized, but did not have the complete staging work-up (33 patients); (3) lastly the extensive disease (32 patients). All of these patients were primarily treated with chemotherapy and radiation therapy was utilized as a palliative modality for local and metastatic symptomatic disease. Prophylac- tic cranial irradiation was used in (5/10) in group I who had achieved complete response. In 18 patients (group I-5, group II-8; group III- 5) with complete local response, median survi-

val of 17 months and in partial responders it