1. Department of Surgery, Siauliai Cancer Center, Lithuania
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

2. Abstracts:
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 ( ) 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 (c2= ;k=628; T=2.264;P=0.024), humoral immunity data (c2=20.328; k=13; T=3.496; P=0.0005), cell ratio factors (c2= ; k=65; T=13.258; P=0.0001e-9), LC characteristics (c2=69.514; k=19; T=4.520; P= e-2).

3. Samplings:
Lung Cancer Patients Lived More than 5 Years after Radical Procedures……….59
Lung Cancer Patients Died Because Generalization During First 5 Years After Radical Procedures……………...49
In All……………………………… …108

4. Radical Procedures: Pneumonectomy…………………..45
Upper/Lower Bilobectomy……...…7
Upper Lobectomy………………....44
Lower Lobectomy………………....11
Middle Lobectomy………………….1
In All…………………………...…108

5. Staging: T1……38 N0……63 G1……30 T2……43 N1……20 G2……34
T4…… Stage II…34 Stage III...74
Squamous Cell Carcinoma……….....…56
Adenocarcinoma……………………….46
Large Cell Carcinoma…………………..6

6. Regularities between Lung Cancer Cell Population and Suvival:

7. Regularities between Immune System and 5-Year Survival Lung Cancer Patients:

8. Immune Homeostasis in Prognosis Lung Cancer Patients Survival:

9. Nucloids of Immune Cell Ratio Factors in Prognosis 5-Year Survival Lung Cancer Patients:

10. Correlations of Immune Cell Ratio Factors with Lung Cancer Patients Survival:

11. SEPATH-Model: Immune Cell Ratio Factors-Survival Lung Cancer Patients:

12. Immune Cell Ratio Factors in Prediction 5-Year Survival:

13. Logistic Regression Model: Immune Cell Ratio Factors-Survival Lung Cancer Patients:

14. Logistic Regression Model of System:Immune Cell Ratio Factors-Survival Lung Cancer Patients:

15. Models (T/CC, CD8+/CC and CD4+/CC, Lymph/CC-Life Span of LCP; n=49; 18th:P<0.01; 12th:P<0.001; 6th: P<0.05 and 18th: P<0.01 Degree Polynomial Fit): y=a+bx+cx2+dx 3+…

16. Regression Models (B/CC, O/CC and Mon/CC-Life Span of LCP; n=49; 18th: P<0.001;13th: P<0.01 and 18th: P<0.01 Degree Polynomial Fit): y=a+bx+cx2+dx 3+...

17. Regression Models (IgG, IgA and IgM-Life Span of LCP; n=49; 18th Degree Polynomial Fit): y=a+bx+cx2+dx 3+...

18. SEPATH-Models: Immune Cell Circuit-Lung Cancer Patients Survival:

19. Relationships between Immune Cell Subpopulations and Life Span of Lung Cancer Patients:

20. Immunity Networks and 5-Year Survival of Lung Cancer Patients

21. SEPATH-Models: Immune Homeostasis--Life Span of Lung Cancer Patients:

22. SEPATH-Models: Humoral Immunity, Cancer Cell Population-Life Span of Lung Cancer Patients:

23. Results of Monte Carlo Simulation:

24. Results of Monte Carlo Simulation: Cancer Cell Population--Survival:

25. Networks between Immune Cell Subpopulations, Cancer Cell Populations and 5-Year Survival Lung Cancer Patients:

26. Conclusions:
5-year survival and lifevspan of lung cancer patients after radical procedures 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 (immune cell ratio factors);
5) cancer characteristics.

27. okshivets@yahoo.com kshivets@hotmail.com
Oleg Kshivets, M.D., Ph.D Thoracic/Abdominal Surgeon, Department of Surgery
Siauliai Cancer Center, Tilzes:42-16, Siauliai, LT78206, Lithuania
Tel. (37041)416614; Fax (37041)526430
http//:myprofile.cos.com/Kshivets