The presence of intraepithelial CD45RO+ cells in resected lymph nodes with metastases from NSCLC patients is an independent predictor of disease-specific survival

BACKGROUND

Operable non-small cell lung cancer (NSCLC) patients whose tumours have spread to regional or central lymph nodes at the time of diagnosis have dismal prognoses compared with those who have limited disease. The current TNM staging system for NSCLC poorly distinguishes patients with lymph-node metastases who will succumb to, and those who will eventually be cured from, their disease. This novel study: (1) evaluates the presence of different subsets of intraepithelial tumour-infiltrating lymphocytes (TILs) in lymph nodes with metastases from NSCLC patients; (2) explores the impact of intraepithelial TILs in lymph nodes on survival; (3) correlates their presence with both intraepithelial and stromal TILs in their corresponding primary tumours.

METHODS

Metastatic lymph-node tissue from 143N+ NSCLC patients was collected and tissue microarrays were constructed. Immunohistochemistry was used to evaluate the presence of intraepithelial CD3+, CD4+, CD8+, CD20+ and CD45RO+ TILs and their impact on survival.

RESULTS

A high level of intraepithelial CD45RO+ TILs in lymph-node metastases from N+ NSCLC patients was an independent positive prognostic factor for disease-specific survival in all patients (HR=0.58, P=0.029) and in squamous cell carcinoma (HR=0.31, P=0.006), but not in adenocarcinoma patients.

CONCLUSIONS

The presence of intraepithelial CD45RO+ cells in lymph-node metastases from N+ NSCLC patients predicts favourable disease-specific survival and outperforms the established TNM staging system in the SCC subgroup.

The effect of climate change on urban drainage: an evaluation based on regional climate model simulation

That we are in a period of extraordinary rates of climate change is today evident. These climate changes are likely to impact local weather conditions with direct impacts on precipitation patterns and urban drainage. In recent years several studies have focused on revealing the nature, extent and consequences of climate change on urban drainage and urban runoff pollution issues. This study uses predictions from a regional climate model to look at the effects of climate change on extreme precipitation events. Results are presented in terms of point rainfall extremes. The analysis involves three steps: Firstly, hourly rainfall intensities from 16 point rain gauges are averaged to create a rain gauge equivalent intensity for a 25 x 25 km square corresponding to one grid cell in the climate model. Secondly, the differences between present and future in the climate model is used to project the hourly extreme statistics of the rain gauge surface into the future. Thirdly, the future extremes of the square surface area are downscaled to give point rainfall extremes of the future. The results and conclusions rely heavily on the regional model's suitability in describing extremes at timescales relevant to urban drainage. However, in spite of these uncertainties, and others raised in the discussion, the tendency is clear: extreme precipitation events effecting urban drainage and causing flooding will become more frequent as a result of climate change.