Reduced expression of thrombospondin-1 correlates with a poor prognosis in patients with non-small cell lung cancer

Thorombospondin-1 (TSP-1) is a 450 kDa extracellular matrix glycoprotein, with anti-angiogenic activity. We analyzed the relationship in TSP-1 expression and Microvessel count (MVC), and also clinical factors, using immunohistochemical methods for non-small cell cancer (NSCLC). Histopathologically, there was inverse correlation between TSP-1 expression and MVC for squamous cell carcinoma, but not for adenocarcinoma cases. Among 199 completely resected cases of NSCLC, the 5-year survival was 77.0% when the expression of TSP-1 was maintained and 55.1% when the expression were reduced, respectively (P=0.0046). When compared with TSP-1 expression in the high MVC subgroup, there was significantly shorter survival time when TSP-1 expression was reduced (P=0.0091), and no significant difference was seen for the low MVC subgroup. Multivariate analysis revealed that expression of TSP-1 is as a prognostic factor of NSCLC. Our present data suggest that TSP-1 might not be a direct anti-angiogenic factor and the TSP-1 expression is a prognostic indicator of NSCLC.     

ERCC1 expression by immunohistochemistry and EGFR mutations in resected non-small cell lung cancer

Expression of excision repair cross-complementation group 1 (ERCC1) is important for resistance to platinum agents. Mutations of epidermal growth factor receptor (EGFR) are related to the responsiveness to tyrosine kinase inhibitors in non-small cell lung cancer (NSCLC). This study was performed to determine if ERCC1 expression and EGFR are related to the prognosis of resected NSCLC, and to determine if ERCC1 expression and EGFR mutations are related. We used immunohistochemistry (IHC) to evaluate ERCC1 expression in tumors from 130 patients with curatively resected NSCLC. The median H-score was used as a cut-off for ERCC1 IHC. EGFR mutations were analyzed in exons 18, 19 and 21. ERCC1 expression was detected in tumors from 80 patients (61.5%). ERCC1 was expressed more frequently in smokers and in squamous cell carcinomas. Patients with a positive ERCC1 expression survived longer than ERCC1-negative patients (median overall survival 7.6 years for ERCC1-positive vs. 4.0 years for ERCC1-negative, P=0.046). Subsequent multivariate analysis suggested that ERCC1 expression is an independent prognostic marker of longer survival (hazard ratio: 0.598, 95% confidence interval: 0.357-1.001). EGFR mutations were found in 25 patients (19.2%) but did not affect overall survival. Interestingly, EGFR mutations were more frequent in ERCC1-negative tumors (12.5% in ERCC1-positive vs. 30% in ERCC1-negative tumors, P=0.014). In conclusion, ERCC1 expression was identified as a positive prognostic marker in resected NSCLC. In addition, EGFR mutations were more frequently found in ERCC1-negative tumors.     

MMP-14 overexpression correlates with poor prognosis in non-small cell lung cancer

Matrix metalloproteinase-14 (MMP-14) has been demonstrated to play an important role in tumor progression. The aim of this study was to analyze the correlation between MMP-14 expression and clinicopathologic features and its prognostic significance in non-small cell lung cancer (NSCLC). Immunohistochemical staining for MMP-14 protein was performed in 104 patients with NSCLC. High levels of MMP-14 protein were positively correlated with the status of clinical stage (I–II vs. III–IV; P?P?P?=?0.014), and differentiated degree (high vs. low or undifferentiated; P?=?0.001). The patients with higher MMP-14 expression of protein had shorter survival time than patients with low MMP-14 expression. Multivariate analysis indicated that the level of MMP-14 expression was an independent prognostic indicator (P?NSCLC. In conclusion, MMP-14 is a potential unfavorable prognostic factor for patients with NSCLC.     

Prognostic significance of p21waf1, cyclin D1 and retinoblastoma expression detected by immunohistochemistry in non-small cell lung cancer.

p21waf1 is a downstream effector of p53, and mediates growth arrest by inhibiting the action of G1 cyclin-dependent kinases. Cyclin D1 is a cell-cycle regulator essential for G1 phases progression and a candidate proto-oncogene implicated in the pathogenesis of several human tumor types. Cyclin D1 overexpression and the absence of retinoblastoma (Rb) protein have been frequently seen in various types of cancer, including lung cancer. The aim of this study was to clarify the relationship between the expressions of p21waf1, cyclin D1, and Rb protein, and to investigate the correlation between these protein expressions and the clinical features of the patients, and their prognoses. We immunohistochemically examined 92 samples of resected non-small cell lung cancer for p21waf1, cyclin D1, and Rb expression. Of the 92 specimens examined, 43 cases (46.7%) showed p21waf1 expression, 23 cases (25.0%) showed cyclin D1 overexpression, and 61 cases (66.3%) showed Rb expression. No correlation was observed between the expressions of p21waf1, cyclin D1, and Rb. There was no association of p21waf1 and cyclin D1 immunoreactivity with gender, disease stage, or histological types of the tumor. Regarding the prognosis in 79 cases with complete resection, no statistical differences were observed according to the degree of expression of these three factors. However, when unfavorable prognostic factors were considered to be the positive expression of p21waf1, positive of cyclin D1, and negative of Rb, the 5-year disease-free survival rate in the group with 2 or 3 unfavorable prognostic factors was 21.1%, which was statistically poorer than the 45.4% in the group with 0 or 1 unfavorable prognostic factor (p=0.0138). We conclude that examination of the expression of cell cycle regulators, such as p21waf1, cyclin D1, and Rb, is useful as a prognostic indicator, when these proteins' expression is analyzed in combination.     

Intratumour variation of biomarker expression by immunohistochemistry in resectable non-small cell lung cancer

BackgroundPrognostic and predictive biomarkers are increasingly used to customise the treatment of patients with solid tumours. Intra- and inter-tumour heterogeneous distribution of biomarker expression is a potential confounder for the use of biomarkers, as small biopsies may not necessarily truly reflect the pattern of biomarker expression. It may also be an important factor in chemo resistance, as tumours with heterogeneous biomarker expression may potentially harbour chemo resistant tumour clones.Materials and MethodsImmunohistochemical evaluation of the expression of excision repair cross complementation group 1 (ERCC1), epidermal growth factor receptor (EGFR), class III-β-tubulin (TUBB-3), thymidylate synthase (TS), Ki-67 and ribonucleotide reductase M1 (RRM1) was performed in 15 separate areas in each of six small microscopically completely resected adenocarcinomas of the lung in order to elucidate any heterogeneous distribution.ResultsClinically relevant biomarker heterogeneity with respect to the expression of EGFR, ERCC1, RRM1, TUBB-3 and Ki-67 was observed in four (66%), four (66%), one (16%), three (50%) and five (83%) out of six tumours, respectively. Thus, heterogeneity could potentially allocate these tumours erroneously into high or low expressers by chance alone, according to previously reported cut-off values. In contrast, TS was almost completely homogenously distributed.ConclusionMost biomarkers examined, except for TS, showed clinically significant intratumour heterogeneity in 33–87% of tumours examined. This heterogeneity may influence results in studies investigating the therapeutic impact of predictive biomarkers in non-small cell lung cancer (NSCLC).     

MCAM expression is associated with poor prognosis in non-small cell lung cancer

Background

MCAM has been recently identified as a biomarker for epithelial–mesenchymal transition (EMT) and is potentially involved in metastasis of cancer. The current study aimed at investigating the expression of MCAM in non-small-cell lung cancer (NSCLC) and its clinico-pathological significance.

Methods

A follow-up analysis was performed on 118 patients with NSCLC resected by lobectomy or pneumectomy with systematic lymph node dissection. All patients were followed for 6–60 months. Immunostaining of tissue sections from primary tumors and their lymph node metastasis was performed and evaluated using monoclonal antibody against MCAM, E-cadherin, and vimentin. Correlations were investigated between MCAM immunostaining in primary tumors and E-cadherin, vimentin immunostaining, lymph node metastasis, and survival.

Results

MCAM protein expression was found in 46.61 % of squamous cell carcinomas and 37.47 % of adenocarcinomas; MCAM expression positively correlated with vimentin, but inversely with E-cadherin (both P values <0.05). There were significant correlations between the MCAM immunostaining score in primary tumors and in their lymph node metastasis (P = 0.03). According to the Kaplan–Meier survival estimate, the level of MCAM expression in primary tumors was a statistically significant prognostic factor (P < 0.05).

Conclusions

MCAM expression in surgically treated NSCLC is clearly associated with lymph node metastasis and poor prognosis.     

Epidermal growth factor receptor expression correlates with poor prognosis in non-small cell lung cancer patients with p53 overexpression

To determine whether cancer patients with tumor suppressor gene abnormality survive for a shorter time when their growth was stimulated by growth factors, we examined 290 non-small cell lung cancer (NSCLC) specimens for p53 and epidermal growth factor receptor (EGFR) protein expressions using immunohistochemical staining. The distribution of cases by pathological stage of tumor was 155 cases of stage I, 30 cases of stage II, 96 cases of stage III and 9 cases of stage IV. Pathological types were 142 adenocarcinomas, 127 squamous cell carcinomas, 17 large cell carcinomas and 4 other types of malignancy. Immunohistochemical staining was performed on the formalin fixed, paraffin-embedded materials with monoclonal antibodies DO-7 and clone EGFR.133. positive staining for EGFR was seen in 124 (42.8%) cases. More EGFR positive cases were found in squamous cell carcinomas than in non-squamous cell carcinomas (p=0.0121). Staining for p53 protein was observed in 147 (50.7%) specimens. Multivariate proportional hazard model analyses revealed EGFR protein expression as a risk factor in the patients with NSCLC (p=0.0240). Patients negative for both EGFR and p53 survived for a longer period of time (p=0.0427).     

非小细胞肺癌组织芯片中RRM1表达和预后因子分析

背景与目的 RRM1与非小细胞肺癌的预后可能有关。本研究的目的是采用组织芯片技术检测非小细胞肺癌中RRM1的表达并分析预后因素。方法 取广东省肺癌研究所标本库的417例非小细胞肺癌术后标本制作成组织芯片。通过SP法检测RRM1的表达情况并分析其与预后的关系。结果 RRM1在不同的性别、年龄、肿瘤部位、病理类型、分化程度、T状态、N状态、M状态和病理分期等组间的差异均无统计学意义（P均〉0．05）。单因素分析显示RRM1表达不是有统计学意义的预后因素（P〉0．05）。COX模型多因素分析显示，分化程度、N状态是独立的预后因素。结论 通过免疫组化检测的RRM1表达不能作为非小细胞肺癌独立的预后因素。TNM分期仍然是目前最好的预后因素。     

CUG-binding protein 1 (CUGBP1) expression and prognosis of non-small cell lung cancer

Background and aims

Non-small cell lung cancer (NSCLC) is the leading cause of cancer mortality worldwide. As CUGBP1 may also play a great role in tumor genesis and deterioration, the purpose of this study was to detect the expression of CUGBP1 mRNA and CUGBP1 and assess the prognostic significance of CUGBP1 in NSCLC.

Methods

Expression of CUGBP1 mRNA and CUGBP was detected by Semi-quantitative PCR and Immunohistochemistry, respectively, from 57 NSCLC patients. The percentage of CUGBP1 mRNA and CUGBP1 expression was correlated with clinical characteristics using χ ² test. The prognostic significance was assessed by univariate and multivariate analyses in the Cox hazard model.

Results

The expression of CUGBP1 mRNA and CUGBP1 was over-expressed in cancer group and was correlated with TNM stage and Differentiation. By both univariate and multivariate survival analyses, CUGBP1 expression (P = 0.0074, HR = 3.701, 95 % CI 1.420–9.648), TNM-stage (HR = 4.043, 95 % CI 2.098–7.794) and age (HR = 3.207, 95 % CI 1.544–6.664) were noted to be independent indicators of a shorter postsurgical survival.

Conclusions

The expression of CUGBP1 independently predicted a shorter postsurgical survival in NSCLC.     

hMLH1基因启动子甲基化与非小细胞肺癌细胞顺铂耐药方面的研究

背景与目的：hMLH1启动子甲基化是肺癌发生、发展的因素之一,但与肺癌细胞耐药方面的研究尚未见报道,本研究旨在探讨是否能通过去甲基化作用恢复hMLH1基因表达从而逆转A549/DDP细胞对顺铂的耐药。方法：RT-PCR检测A549及A549/DDP细胞的hMLH1表达情况,及5-氮杂-2＇-脱氧胞苷（5-Aza-2＇-eoxycytidine,5-Aza-CdR）干预A549/DDP细胞后hMLH1表达情况;MSP检测A549、A549/DDP细胞及5-Aza-CdR干预A549/DDP细胞后hMLH1甲基化状态。MTT试验、Hoechst33258染色、流式细胞仪（FCM）分别观察5-Aza-CdR干预前后顺铂对A549/DDP细胞抑制率、凋亡的形态学变化和凋亡指数。结果：hMLH1mRNA在A549中的表达高于A549/DDP细胞;A549细胞hMLH1为非甲基化状态,A549/DDP细胞为部分甲基化状态,经5-Aza-CdR去甲基作用后hMLH1呈非甲基化状态;A549组、A549/DDP组、经10μmol/L5-Aza-CdR干预后的A549/DDP组经顺铂作用后的IC50值分别为（4.7&#177;0.7）、（30.1&#177;1.8）和（6.9&#177;0.6）μmol/L;5-Aza-CdR干预后的A549/DDP细胞经顺铂作用后,比单用顺铂抑制A549/DDP细胞的凋亡形态学改变明显,凋亡小体以及核固缩现象增多。结论：hMLH1甲基化可能参与了A549/DDP细胞的顺铂耐药过程;5-Aza-CdR能抑制hMLH1甲基化,恢复hMLH1表达,并能增强顺铂对A549/DDP细胞增殖抑制和凋亡。     

转移相关蛋白1与非小细胞肺癌转移及预后关系研究

背景与目的转移是导致临床肺癌患者死亡的主要原因,因此对肺癌转移研究一直是医学科研关注的热点。转移相关蛋白1(metastasis-associated protein1,MTA1)是转移相关蛋白家族成员之一,其表达增高与乳腺癌及食管癌的侵袭转移能力呈正相关。但其表达的普遍性及对判定肿瘤生物学特性和评估预后的意义仍有待于进一步研究。本研究旨在探讨MTA1在非小细胞肺癌组织中表达及与患者临床病理特征之间的关系,明确其对判断肺癌患者转移潜能和预后的意义。方法采用免疫组织化学染色(SP法)检测101例具有完整随访资料的非小细胞肺癌石蜡包埋组织标本中MTA1的表达,并联合应用Western blot方法对35例新鲜非小细胞肺癌组织及相应癌旁正常组织中MTA1的表达进行研究。结果免疫组织化学结果显示:MTA1主要表达在癌细胞核中,阳性表达率为55.4%(56/101);癌旁正常支气管上皮或肺泡上皮阴性表达。Western blot结果证实:MTA1在35例肺癌组织中的表达较相应癌旁正常肺组织明显增高(t=3.953,P=0.000),有淋巴结转移的MTA1表达较无淋巴结转移的增高(t=4.057,P=0.000)。χ2检验显示MTA1表达与细胞分化程度(χ2=10.131,P=0.006)、淋巴结转移(χ2=8.535,P=0.003)和临床分期(χ2=17.419,P=0.000)有密切关系。生存曲线分析表明MTA1阴性表达的非小细胞肺癌患者术后生存期为44.866月±12.946月,阳性表达者为23.714月±7.498月(χ2=10.006,P=0.002)。Cox多因素分析显示仅淋巴结转移和临床分期是影响患者预后的独立风险因素。结论MTA1在非小细胞肺癌组织中表达较正常肺组织明显增高,有淋巴结转移肺癌组织中的表达较无淋巴结转移肺癌组织明显增高。MTA1与非小细胞肺癌的分化程度、淋巴结转移、临床分期和患者的预后有关,但不能作为患者预后评估的独立指标。     

Loss of Bad expression confers poor prognosis in non-small cell lung cancer

Proapoptotic BH-3-only protein Bad (Bcl-Xl/Bcl-2-associated death promoter homolog, Bad) initiates apoptosis in human cells, and contributes to tumorigenesis and chemotherapy resistant in malignancies. This study explored association between the Bad expression level and prognosis in patients with non-small cell lung cancer (NSCLC). In our study, a cohort of 88 resected primary NSCLC cases were collected and analyzed. Bad expression level was determined via immunohistochemical staining assay. The prognostic significances of Bad expression were evaluated with univariate and multivariate survival analysis. The results showed that compared with normal lung tissues, Bad expression level significantly decreased in NSCLC (P < 0.05). Bad expression was associated with adjuvant therapy status. Loss of Bad independently predicted poor prognosis in whole NSCLC cohort and early stage subjects (T1 + T2 and N0 + N1) (all P < 0.05). Overall survival time was also drastically shortened for Bad negative phenotype in NSCLC patients with smoking history, especially lung squamous cell carcinoma (all P < 0.05). In conclusion, this study provided clinical evidence that loss of Bad is an independent and powerful predictor of adverse prognosis in NSCLC. Bad protein could be a new biomarker for selecting individual therapy strategies and predicting therapeutic response in subjects with NSCLC.     

High Sam68 expression predicts poor prognosis in non-small cell lung cancer

Background

The nuclear protein Sam68 has been implicated in the oncogenesis and tumor growth. The aim of this study was to explore the clinical value of Sam68 in patients with non-small cell lung cancer (NSCLC).

Methods

We examined Sam68 expression in 50 NSCLC tissues and matched adjacent noncancerous tissues by quantitative RT-PCR (qRT-PCR) and Western blotting. Furthermore, the Sam68 protein expression was analyzed by immunohistochemistry in 208 NSCLC samples. Kaplan–Meier method and multivariate Cox regression model were used to evaluate the prognostic value of nuclear Sam68 expression in NSCLC for disease survival.

Results

The expression of Sam68 was significantly elevated in NSCLC tissues as compared with adjacent non-cancerous tissues (P < 0.01). The high expression of Sam68 in NSCLC was significantly correlated with lymph node metastasis and tumor TNM stage. Kaplan–Meier survival analysis revealed that high expression of Sam68 correlated with poor prognosis of NSCLC patients (P < 0.01). Multivariate analysis showed that Sam68 expression was an independent prognostic marker for overall survival of NSCLC patients (HR 2.73, 95 % CI 1.549–4.315, P = 0.002).

Conclusion

Our results suggest that high Sam68 expression predicts poor prognosis of NSCLC patients, and Sam68 may be potentially a prognostic biomarker for NSCLC.     

Abnormal expression of FLOT1 correlates with tumor progression and poor survival in patients with non-small cell lung cancer

Recent studies have revealed that flotillin-1 (FLOT1) plays important roles in cancer progression. However, the role of FLOT1 in development and progression of non-small cell lung cancer (NSCLC) remains largely unknown. The objective of the current study was to investigate the expression pattern and clinicopathological significance of FLOT1 in patients with NSCLC. Real-time quantitative polymerase chain reaction was applied to examine FLOT1 mRNA expression in 52 pairs of NSCLC tissues and adjacent noncancerous tissues. Immunohistochemistry was performed to examine FLOT1 protein expression in paraffin-embedded tissues from 106 NSCLC patients. Statistical analyses were applied to evaluate the diagnostic value and associations of FLOT1 expression with clinicopathological characteristics. FLOT1 mRNA expression was evidently upregulated in NSCLC tissues compared with that in the adjacent noncancerous tissues. In the 106 cases of tested NSCLC samples, FLOT1 protein level was positively correlated with tumor size, tumor stage, and lymph node metastasis. Patients with higher FLOT1 expression had shorter overall survival time, whereas those with lower FLOT1 expression had longer survival time. Taken together, our findings indicate that FLOT1 may play an important role in NSCLC tumorigenesis. Further elucidation of the molecular mechanisms underlying the role of FLOT1 is warranted.     

ERCC1、RRM1基因表达与非小细胞肺癌患者预后的相关性

目的探讨ERCC1、RRM1基因蛋门表达对Ⅰ～Ⅲa期非小细胞肺癌患者预后的影响。方法采用免疫组化法检测Ⅰ～Ⅲa期非小细胞肺癌患者ERCC1、RRM1蛋白表达情况;采用生存分析曲线分析其对生俘预后的影响。结果ERCCl、RRMl蛋白表达与患者性别、年龄、病珲类型和TNM分期等莘异均无统计学意义（P〉0．05）。在TNM分期中,Ⅰa期ERCCl、RRM1阳性表达组生存预后较好,提示两种基因蛋白的阳性表达在18期患者中是一种保护因素。存IhⅢa期患者中ERCC1表达阴性组可以从含铂化疗方案中获益,可获得生存优势;RRMI表达阴性组对化疗药物吉西他滨敏感,可获得较长的生存优势。在Ⅰ～Ⅲa期患者中ERCC1与RRM1的表达呈正相关,差异有统计学意义（P〈0．05）。结论检测Ⅰ～Ⅲa期非小细胞肺癌ERCCI及RRM1蛋白表达可以预测患者的治疗疗效及预后,使患者从个体化治疗中获益。     

Bmi-1 expression modulates non-small cell lung cancer progression

Previous studies indicate that the role of B lymphoma Mo-MLV insertion region 1 homolog (Bmi-1) is responsible for multiple cancer progression. However, Bmi-1 in controlling gene expression in non-small cell lung cancer (NSCLC) development is not well explored. Here we report that the Bmi-1 level is highly increased in primary NSCLC tissues compared to matched adjacent non-cancerous tissues and required for lung tumor growth in xenograft model. Furthermore, we also demonstrate that Bmi-1 level is lower in matched involved lymph node cancerous tissues than the respective primary NSCLC tissues. We find that Bmi-1 does not affect cell cycle and apoptosis in lung cancer cell lines as it does not affect the expression of p16/p19, Pten, AKT and P-AKT. Mechanistic analyses note that reduction of Bmi-1 expression inversely regulates invasion and metastasis of NSCLC cells in vitro and in vivo, followed by induction of epithelial-mesenchymal transition (EMT). Using genome microarray assays, we find that RNAi-mediated silence of Bmi-1 modulates some important molecular genetics or signaling pathways, potentially associated with NSCLC development. Taken together, our findings disclose for the first time that Bmi-1 level accumulates strongly in early stage and then declines in late stage, which is potentially important for NSCLC cell invasion and metastasis during progression.