Hans Blaauwgeers

42 Chapter 3 Within the subgroup of stage IIB (ypT3N0) cases low MIB-1 tended to be associated with better OS, but not significant (p=0.056), whereas it was significant for DFS (p=0.008). For PDL-1 in this subgroup analysis it was just the other way around, a significant difference for OS (p=0.011), but not for DFS (p=0.13). Morphometry The mean nuclear size of normal lung tissue pneumocytes was significantly smaller compared to the nuclear size of tumour cells of the resection specimens (median difference -38.1 µm2; range -115.2 to 16.0; p<0.001]). This was also the case for median nuclear size and the 75th percentile cut-off points (table 3). Table 3. Median difference [range] in mean nuclear size (in µm2) of normal pneumocytes in resection specimen, pre-operative tumour cells in biopsy and post-chemoradiotherapy tumour cells in resection specimen. mean (µm) p-value mean median (µm2) p-value median 75th percentile (µm2) p-value 75th percentile 90th percentile (µm2) p-value 90th percentile Tumour cells in biopsy vs resection - 4.6 [-75.2 - 86.7] 0.14 -4.2 [-71.8 - 92.7] 0.15 - 4.9 [-107.1 -97.4] 0.046 - 8.5 [-139.8 – 96.0] 0.085 Normal pneumocytes in resection vs tumour cells in resection - 38.1 [-115.2 - 16.0] <0.001 - 34.3 [-105.8 - 15.9] <0.001 - 43.4 [-151.3 - 17.3] <0.001 - 54.7 [-203.0 – 19.0] <0.001 p-values in bold are significant The mean nuclear size of tumour cells in the pre-treatment biopsies showed a tendency to be smaller than those in the resection specimens (median difference -4.6 µm2; range -75.2 to 86.7; p=0.14), while for the 75th percentile the difference in nuclear size was significant (median difference -4.9 µm2; range -107.1 to -97.4; p=0.046; table 3). Nuclear size was not associated with recurrent disease. No differences were found in the mean nuclear size of tumour cells between the 10 patients who are still alive and those 23 who died of their disease, neither in the pre-treatment biopsies (median 61.7 µm2 vs 58.2 µm2; p=0.82), nor in the resection specimens (median 65.1 µm2 vs 69.9 µm2; p=0.43) (table 4). The differences in mean nuclear size in the resection specimens of the survivors compared to their biopsies tended to be smaller than in the non-survivors; but these differences were not significant (median difference -1.1 vs -7.3; p=0.33).

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