[Cellular changes in non-small cell lung cancer after neoadjuvant therapy]

Microscopic analysis of resection specimens of non-small cell lung cancer after neoadjuvant therapy evokes the subjective impression of cytologic changes, especially enlargement of the individual tumor cells and their nuclei. Therefore, objectivization of these changes was tested morphometrically. Corresponding investigations could be carried out in 24 patients who had each received identical neoadjuvant therapy. The diameters and areas of the tumor cells and their nuclei as well as the nucleocytoplasmic ratio were assessed. The adenocarcinomas investigated revealed a significant cellular enlargement after treatment. Moreover, in 18 resection specimens (75%), cytomorphological changes could be shown in comparison to untreated tumor tissue. The cellular and nuclear parameters analysed as well as the cytomorphological changes assessed showed no significant correlation to the grade of therapy-induced tumor regression and thus do not allow an assessment of therapy success. Based on these results, grading of non-small cell lung cancer is not recommended after neoadjuvant therapy and the diagnosis of "large cell anaplastic" carcinoma should be made with reservation.