老年肺癌141例临床分析

目的探讨老年肺癌患者的临床特点。方法收集经病理明确诊断的老年肺癌患者临床资料,回顾性分析患者年龄、性别、ECOG评分、临床症状、病理类型、临床分期、转移部位、合并症等。结果 141例老年肺癌患者平均年龄74.48岁,男女性别比例为4.64∶1,ECOG评分0~1分患者占89.36%;主要症状为咳嗽(66.7%)、胸闷(17.7%)、疼痛(17.7%),61%患者为非小细胞肺癌(NSCLC),T1患者仅5.67%,N2-3患者达78.72%,Ⅲ~Ⅳ期患者高达90%以上。肺、胸膜转移最为常见,而远处转移(M1b)多见于骨、脑、肝脏、肾上腺。合并疾病患者达52.5%。结论老年肺癌患者临床表现无特异性且合并疾病较多,临床分期较晚,但行为状态较好,值得临床进一步关注其早期诊断、治疗及预后。     

Comorbid and clinical determinants of prognosis in endometrial cancer

In cancers of the lung, larynx, rectum, and breast, the patients' initial clinical manifestations and comorbid diseases have shown important prognostic distinctions that are not evident in the customary systems of anatomic staging. This study was done to see whether the same phenomena occurred for cancer of the endometrium. In 142 consecutive cases of endometrial carcinoma, strikingly high five-year survival rates were found in women who had no symptoms attributable to the cancer or whose only symptoms might have been caused either by concomitant uterine or cervical disease or by replacement estrogen therapy. A distinct decline in survival was associated with systemic symptoms and with major comorbid ailments. Estimation of prognosis and evaluation of therapy can be improved with a new composite staging system, formed by combining the new clinical categories and the standard morphologic stages of the International Federation of Gynecology and Obstetrics (FIGO) system.     

Palliative chemotherapy in elderly patients with common metastatic malignancies: A Hellenic Cooperative Oncology Group registry analysis of management, outcome and clinical benefit predictors

INTRODUCTION: Cancer in the elderly is a common health issue in developed societies. We sought to present epidemiology, management and outcome data on fit elderly patients with common metastatic cancers and to identify predictors of clinical benefit from palliative chemotherapy. METHODS: All patients aged >65 years who were diagnosed with metastatic breast, colorectal or non-small cell lung carcinomas and managed with palliative chemotherapy in the context of Hellenic Cooperative Oncology Group (HeCOG) clinical trials or protocols were eligible for electronic data retrieval and analysis. Common eligibility criteria included adequate performance status (ECOG 0-3), organ function and absence of severe co-morbidity forbidding cytotoxic chemotherapy. RESULTS: One thousand three hundred and seventy-two fit patients (PS 0-1 in 73%) with a median age of 70 years diagnosed with metastatic breast (n=250), colorectal (n=621) or lung cancer (n=501) received chemotherapy from 1991 until 2006. Most patients received modern full-dose chemotherapy regimens including platinum, taxanes, anthracyclines, fluoropyrimidines, oxaliplatin or irinotecan. Mild to moderate co-morbidity was present in 35%. At a median follow-up of 3 years, objective responses were seen in 41% of patients with breast cancer, 25% with colorectal cancer and 31% with lung cancer, while median survival was 21, 16 and 9.4 months, respectively. Grade 3 or 4 toxicity was seen in a quarter of patients, the most common being neutropenia (14%), diarrhoea (6%), neurotoxicity (4%), fatigue, nausea and febrile neutropenia (each 2%). In multivariate analysis, diagnosis of colorectal or lung cancer, metastases in multiple organ sites, presence of liver/brain/peritoneal deposits, impaired PS and low baseline serum albumin levels were prognostic factors for adverse outcome. The same factors excluding metastatic sites and with the addition of anemia predicted for resistance to chemotherapy. Toxicity was more likely in females with low serum albumin and renal dysfunction. A six-variable geriatric assessment for palliation (GAP) score that included tumour type, sites of metastatic dissemination, impaired PS, low serum albumin and anemia classified elderly patients to groups with low, intermediate and high risk for disease progression and death (relative risks of 1.59 and 2.50 for resistance to therapy and 1.87 and 3.12 for death in the intermediate and high-risk groups). CONCLUSIONS: Our data indicate that relatively fit elderly patients with advanced cancer safely tolerate modern chemotherapy and enjoy disease control in a manner comparable to younger patients. Our GAP score, if further validated, offers promise for geriatric application in combination to comprehensive geriatric assessment tools for the optimisation of palliative therapy on an individualised basis.     

Prognostic impact of increasing age and co-morbidity in cancer patients: a population-based approach

This large population-based study focuses on the prognostic role of increasing age and co-morbidity in cancer patients diagnosed in the southern Netherlands. Data of patients diagnosed between 1995 and 2002 and recorded in the population-based Eindhoven Cancer Registry were used. Older patients (with serious co-morbidity) with non-small cell lung cancer or prostate cancer underwent surgery less often than younger patients. Elderly with stage III colon cancer, small cell lung cancer, FIGO II or III ovarian cancer or non-Hodgkin's lymphoma (NHL) received (adjuvant) chemotherapy less often, probably because of the higher rate of haematological complications. Administration of adjuvant radiotherapy decreased with age and co-morbidity in patients with rectal cancer, limited small cell lung cancer or breast cancer. In general, elderly did not suffer from more complications than younger patients, except for cardiac complications (colorectal cancer and NHL) and postoperative death (non-small cell lung cancer). For most tumours relative survival was lower for the elderly, except for patients with colon cancer, prostate cancer or indolent NHL. Co-morbidity had an independent prognostic effect, except for tumours with a very poor prognosis. Future prospective studies should investigate whether the guidelines for cancer treatment should be adjusted for elderly with serious co-morbidity.     

Classification of lung cancer: first experiences with the new TNM classification (4th edition).

In January 1987, the 4th edition of the TNM classification for malignant lung tumours by the International Union Cancer (UICC) came into effect. Thus, for the first time, a uniform worldwide staging system for lung cancer became available. In order to validate the new TNM definitions for lung cancer the data of 3,000 patients were analysed prospectively. Several items were examined: 1) the agreement between clinically (TNM) and pathologically (pTNM) confirmed classification; 2) the value of the various diagnostic techniques estimating the pathologically confirmed classification; 3) the influence of the TNM definitions on separating distinct prognostic groups. With regard to the primary tumour (T), clinical and pathological classifications were identical in 64%; for lymph node involvement (N) the agreement was 48%; for distant metastases it was 90% and for the stages it was 55%. As for the primary tumour (T) the accuracy of radiography (59%) was nearly identical to computed tomography (58%). Both techniques were less precise in determining the extent of lymph node involvement (computed tomography 50%, radiography 43%, correct assessments). The statistically significant differences in prognosis for the various T-, N- and M-categories as well as for the stages could be confirmed. By the new 1987 TNM definitions (4th edition) for lung cancer international conformity became feasible as well as practical, and the improvement in its prognostic relevance provided, therefore, a more reliable basis for establishing guidelines for individual oncological concepts of therapy.     

耐多药相关蛋白基因表达与肺癌病理特征关系的研究

目的　探讨耐多药相关蛋白（ Ｍ Ｒ Ｐ） 基因表达与肺癌病理特征的关系。方法　应用逆转录聚合酶链反应（ Ｒ Ｔ Ｒ Ｃ Ｒ） 技术对３５ 例原发性肺癌、癌旁组织及２８ 枚淋巴结中 Ｍ Ｒ Ｐ 基因的表达进行检测、分析。结果　肺癌组织及癌旁组织中 Ｍ Ｒ Ｐ阳性率分别为５４ ％ 和１４ ％ ,两者比较差异有显著性（ Ｐ＜ ０００５） ;转移淋巴结组织 Ｍ Ｒ Ｐ阳性率为５３ ％ ;各病理类型中不同分化程度肿瘤的 Ｍ Ｒ Ｐ阳性分布不同,术前化疗病例的 Ｍ Ｒ Ｐ阳性率（７８ ％ ） 高于未化疗者（４６ ％ ） 。随诊发现, Ｍ Ｒ Ｐ 阳性者肿瘤复发、转移的发生率（５５ ％ ） 高于 Ｍ Ｒ Ｐ阴性者（１５ ％ ） 。结论　原发性肺癌 Ｍ Ｒ Ｐ 基因表达增高,术前化疗可能起诱导作用。癌组织与其转移淋巴结中 Ｍ Ｒ Ｐ表达具有一致性, Ｍ Ｒ Ｐ的过度表达与肿瘤的大小、临床分型、 Ｔ Ｎ Ｍ 分期无明显关系,但可能提示肿瘤的预后不良。     

Clinicopathological and prognostic significance of circRNAs in lung cancer: A systematic review and meta-analysis

Background:Circular RNAs (circRNAs) regulate multiple pathways during lung cancer pathogenesis. Apart from functional significance, many circRNAs have been shown to be associated with clinicopathological characteristics and predict lung cancer prognosis. Our aim is to summarize the expanding knowledge of clinical roles of circRNAs in lung cancer.Methods:A thorough search of literature was conducted to identify articles about the correlation between circRNA expression and its prognostic and clinicopathological values. Biological mechanisms were summarized.Results:This study included 35 original articles and 32 circRNAs with prognostic roles for lung cancer. Increased expression of 25 circRNAs and decreased expression of 7 circRNAs predicted poor prognosis. For non-small cell lung cancer, changes of circRNAs were correlated with tumor size, lymph node metastasis, distant metastasis, tumor node metastasis (TNM) stage, and differentiation, indicating the major function of circRNAs is to promote lung cancer invasion and migration. Particularly, meta-analysis of ciRS-7, hsa_circ_0020123, hsa_circ_0067934 showed increase of the 3 circRNAs was associated with positive lymph node metastasis. Increase of ciRS-7 and hsa_circ_0067934 was also related with advanced TNM stage. The biological effects depend on the general function of circRNA as microRNA sponge.Conclusions:CircRNAs have the potential to function as prognostic markers and are associated with lung cancer progression and metastasis.     

青年与老年肺癌患者临床特征回顾性分析

目的探讨现今发病青年与老年肺癌患者的临床特点。方法收集经病理检查明确诊断的≤40岁青年以及≥70岁老年肺癌患者的临床资料,回顾性分析两组患者年龄、性别比例、ECOG评分、症状、病理类型、分子分型、临床分期、转移部位、合并症等。结果两组患者平均年龄分别为34.88岁、74.48岁;青年组男女性别比例为0.93,而老年组男女比例为4.64,两者比较有显著性差异(P0.005);青年组ECOG评分0分患者多于老年组,但绝大多数患者为0-1分,两组无统计学差异;两组患者主要症状均为咳嗽、胸闷、疼痛(P0.1);青年组78.57%为腺癌,老年组小细胞肺癌、鳞状细胞癌占52.48%(74/141);青年组EGFR阳性率达55.36%(31/56),查见驱动基因比例高达64.29%(36/56);青年组0-Ⅱ期患者为25%,而老年组Ⅲ-Ⅳ期患者高达90%,两组有显著性差异(P0.01)。两组均以肺、胸膜转移最为常见,远处转移(M1b)也多见于骨、脑、肝脏、肾上腺;老年组患者合并疾病达52.5%,明显多于青年组。结论两组患者临床表现均无特异性、临床分期多较晚,但行为状态均较好;青年肺癌患者腺癌很常见,且存在驱动基因几率较高,而老年患者男性多见,小细胞肺癌及鳞癌、合并基础疾病常见,值得临床进一步关注其早期诊断、治疗、预后及预防。     

Expression of bcl-2 protein in non-small cell lung cancer: correlation with clinicopathology and patient survival.

Molecular genetic studies have revealed mutations in a number of oncogenes and tumor suppressor genes in lung cancer. The bcl-2 gene product (bcl-2 protein) is implicated in oncogenesis by its ability to prolong cell death through the inhibition of apoptosis. We investigated expression of bcl-2 in 84 resected human non-small cell lung cancers (NSCLC) and correlated this phenomena with clinicopathology and survival. Immunohistochemical analysis with a monoclonal antibody specific for bcl-2 (Clone 124; Dako) was used to detect the protein in tumor samples. Overall, bcl-2 was detectable in 39 of 84 (46%) NSCLC. The percentage of bcl-2 positive cases varied according to the histological type. Positive bcl-2 immunostaining was observed in 27 of the 46 squamous cell carcinomas (59%), 7 of the 25 adenocarcinomas (28%) and 5 of the 13 large cell carcinomas (38%). The frequency of positive bcl-2 expression in squamous cell carcinomas was significantly higher than that in other histological two types (p = 0.037). Statistical comparisons between the patients' clinical characteristics and bcl-2 status revealed no significant differences in the frequency of bcl-2 expression with respect to sex, T and N factors, as well as TNM stage. The relationship between bcl-2 protein expression and postoperative survival was analyzed in 84 patients. Patients with bcl-2 negative tumors showed significantly shorter survival times than those with bcl-2 positive tumors. In univariate analysis of various potential prognostic factors only TNM stage and bcl-2 test were significant prognostic factors (p < 0.009 and p < 0.008, respectively). In multivariate analysis (Cox proportional hazard model), bcl-2 status (negative test) was independent unfavorable prognostic factor (p = 0.017). In conclusion, this set of observations suggests that assessment of the expression status of bcl-2 by tumors may provide prognostic information on the clinical behavior of NSCLC.     

A comparison of the prognostic significance between the number of metastatic lymph nodes and nodal stage in gastric carcinoma

BACKGROUND/AIMS: To clarify what staging system of lymph node metastasis is suitable for evaluating prognosis of gastric cancer patients. METHODOLOGY: We analyzed the survival 5 years after operation of 186 advanced gastric cancer patients who underwent potentially curative gastric resection. The following 3 systems were compared using multivariate analyses by the logistic regression model. Nodal status in pathology was classified as follows: (a) nodal stage according to the General Rules for the Gastric Cancer Study of the Japanese Research Society for Gastric Cancer (the Japanese Rules), (b) number of metastatic nodes according to the new UICC staging system (the TNM system), (c) number of metastatic nodes in n1 group of the Japanese Rules (the new classification). RESULTS: The TNM system revealed better results than the nodal stage in sensitivity and -2 log likelihood. The new classification revealed the best result among the 3 systems in sensitivity, specificity, accuracy and -2 log likelihood. CONCLUSIONS: The TNM system is a better prognostic factor than the nodal stage in the Japanese Rules, and the new classification is the best prognostic factor of the above 3 systems in potentially curative advanced gastric cancer patients. Furthermore, the new classification might be useful in comparing data between some facilities.     

肺结核合并肺癌56例临床特点及预后分析

目的 探讨56例肺结核合并肺癌患者的临床特点及预后.方法 纳入我院诊治的肺结核合并肺癌患者（A组）56例、单纯肺结核患者（B组）58例.比较两组患者性别、发病年龄及临床症状等临床特点,并对相关因素与肺结核合并肺癌患者预后的关系进行研究.结果 两组患者性别无显著差别（P〉0.05）;A组患者年龄显著高于B组患者（P〈0.05）;A组痰血、消瘦比例显著多于B组患者（P〈0.05）;A组患者生存期与肺叶切除范围、是否为原结核处恶变及TNM分期相关.结论 肺结核合并肺癌患者与单纯肺结核临床症状鉴别诊断困难,肺叶切除范围、是否为原结核处恶变及TNM分期是影响肺结核合并肺癌预后的影响因素.     

Clinical analysis of primary duodenal adenocarcinoma: an 11-year experience

Background and Aim: The impact of obstructive jaundice (OJ) complicated by primary duodenal adenocarcinoma (PDA) on survival, and its treatment options, has rarely been mentioned in literature. The aim of the present study was to review the clinical features of PDA patients in an attempt to determine the prognostic factors and the influence of OJ on survival. Methods: From May 1994 to February 2005, all duodenal malignancies treated at Kaohsiung Chang Gung Memorial Hospital were reviewed. Preliminary findings were made on a total of 116 duodenal adenocarcinoma (DA) cases. After excluding metastatic DA and the papilla of Vater cancer, 23 patients (19.8%), confirmed as having PDA, were enrolled. Results: Among the 23 predominantly male patients with a mean age of 68 years, abdominal pain was the most common symptom. Major tumor origin was the second portion, and the predominantly cytological feature was moderate differentiation. Tumor‐node‐metastasis (TNM) cancer stage IV accounted for 47.8% of the patients, and cancer‐directed surgeries (CDS) were performed on 11 patients. Seven patients experienced complications due to OJ, which could be a sign of grave prognosis predicting survival of less than 1 year. Four of the patients received internal or external biliary drainage before CDS or palliative surgeries. Cigarette smoking, cytology, TNM stage, aspartate aminotransferase (AST), OJ, and CDS were significant factors of overall survival in a univariate analysis. The independent predictors of long‐term survival were CDS, TNM stage, cytology, cigarette smoking, and AST using the Cox proportional hazard model. Conclusion: PDA patients who did not smoke and who were eligible for and received CDS had better prognostic outcomes.     

抑癌蛋白维生素D3上调蛋白1在肺癌组织中的表达及意义

目的 探讨肿瘤抑制蛋白维生素D3上调蛋白1(vitamin D3 up-regulated protein 1,VDUP1)在肺癌组织中的表达及其与肺癌临床、病理之间的关系和意义.方法 应用RT-PCR及Western blot分别检测35例肺癌患者的癌组织及癌旁正常组织VDUP1 mRNA和蛋白表达水平,进一步按照癌...     

血细胞因子在肺癌分型及预后中的临床意义

目的探讨细胞因子在肺癌不同病理类型和预后判断中的意义。 方法收集就诊于上海交通大学附属仁济医院的127例肺癌患者以及11例支气管哮喘、68例社区获得性肺炎患者的临床数据,包括病理类型、生存时间、临床分期、年龄等,同时收集这些患者多次入院病程中外周血细胞因子和肺癌相关肿瘤指标的实验室检查资料。统计分析细胞因子在肺癌、支气管哮喘和社区获得性肺炎中的表达差异。筛选出肺癌患者中升高的细胞因子,并统计分析它与肺癌分期、病理类型及预后的相关性。 结果IL-6在肺癌患者中的水平明显高于支气管哮喘和社区获得性肺炎组(P<0.001),而其它的细胞因子在这三种疾病中的表达无明显差异。IL-6在肺鳞癌患者中升高最为明显;IL-6水平的高低与临床TNM分期相关,在Ⅲ、Ⅳ期肺癌患者中最高(P<0.05)。在肺癌的死亡患者中,血IL-6的水平随疾病的进展逐步升高,相关回归分析具有统计学差异(P<0.01)。生存分析显示IL-6高水平组的生存时间短于IL-6低水平组,风险比为3.04(P<0.05)。 结论IL-6与肺癌患者病情进展及预后相关。     

Angiogenesis and dendritic cell density are not correlated with metachronous distant metastasis in curatively operated rectal cancer

BACKGROUND AND AIMS: Apart from surgery, treatment of rectal cancer increasingly involves the use of (neo-)adjuvant strategies. To optimize the selection process for these therapy regimens, especially in the field of cellular and molecular biology, new prognostic factors additional to the established TNM system are being investigated. PATIENTS AND METHODS: Two groups of patients ( n=2x85) with rectal carcinoma curatively treated by surgery alone were studied retrospectively (median follow-up 6.1 years). To exclude the effect of the surgeon only patients free of locally recurrent disease were selected. Patient groups were matched for age, gender, UICC stage, and year of operation (1982-1991) and differed only in subsequent metachronous distant metastatic spread, i.e., the criterion to be studied. The factors investigated in uni- and multivariate analysis were angiogenesis, density of dendritic cells, grading, venous invasion, and lymphatic invasion. RESULTS: Grading invariably proved to be the only significant prognostic factor. In univariate analysis the absence of venous invasion was also correlated significantly with increased disease-free survival. CONCLUSION: Angiogenesis and dendritic cell density are not prognostic factors for metachronous distant metastasis in rectal cancer and therefore cannot serve as selection parameters for adjuvant therapy.     

Prognostic value of lymph node staging in gastric cancer

BACKGROUND/AIMS: The latest TNM classification (5th edition) changed the definition of nodal staging from the anatomical localization to the total number of metastatic lymph nodes. This study was designed to evaluate and compare the prognostic significance of nodal staging between the two widely known staging systems, the TNM classification (TNM) and Japanese Classification for Gastric Cancer (JCGC). METHODOLOGY: A total of 582 patients who underwent curative gastrectomy with extended lymphadenectomy for gastric cancer were reviewed retrospectively from hospital records. Based on the localization of metastatic nodes according to the JCGC and the total positive node number according to TNM, the patients were divided into subgroups and their prognoses compared. RESULTS: Lymph node metastasis was found in 189 of the 582 patients (32.5%). Both nodal staging systems were found to be significant prognostic factors by multivariate analysis. A prognostic analysis of the patients by subdivision with the two staging systems indicated that the nodal staging system in TNM was more homogenous than that of the JCGC. CONCLUSIONS: The nodal staging system of the TNM classification is superior to that of the Japanese Classification of Gastric Cancer, because it is simple, reproducible and homogeneous.     

Clinical features and outcome of pneumonia in patients with lung cancer]

We reviewed our experience with pneumonia in patients with lung cancer over a 14-year period at Kurume University Hospital. We examined the clinical features and significance of pathogenic microbes isolated from sputum in patients with lung cancer complicated by pneumonia. Many investigators have noted that patients with squamous cell lung cancer tend to contract pneumonia more readily than patients with cancers of other histopathological types. Our review, however, disclosed no significant differences among histopathological types. Bacteriological examinations of sputum revealed the frequent involvement of Staphylococcus aureus, Enterococcus faecalis, and various gram-negative organisms (e.g., Pseudomonas, Acinetobacter, Enterobacter, and Klebsiella species) that are known to be causative agents of hospital-acquired infection. Beta-lactam and CLDM were less effective. Carbapenem used alone as the second regimen of treatment for lung cancer patients with pneumonia was found to be as effective as combination therapy with beta-lactam and aminoglycoside. However, more detailed investigations (e.g., randomized prospective studies) will be needed to identify suitable antibiotics against pneumonia in patients with lung cancer. We concluded that it will be necessary to evaluate the clinical features and outcome of pneumonia in lung cancer patients in order to provide more effective treatment.     

Angiogenesis and cancer: A cross-talk between basic science and clinical trials (the "do ut des" paradigm)

Angiogenesis plays a crucial role in facilitating tumor growth and the metastatic process, and it is the result of a dynamic balance between pro-angiogenic factors, like vascular endothelial growth factor (VEGF) and platelet-derived growth factor, and antiangiogenic factors, like thrombospondin-1 and angiostatin. Many drugs that target human tumors, like bevacizumab and some VEGF-receptor tyrosine-kinase inhibitors (e.g., BAY 43-9006, SU11248 and PTK787/ZK222584) have been studied in clinical trials, with favorable toxicity reports and encouraging results in advanced colorectal cancer, renal cell cancer, breast cancer and non-squamous non-small cell lung cancer, either combined with chemotherapy, or in monotherapy. Another potential approach to inhibiting angiogenesis is through metronomic chemotherapy (low doses of chemotherapy for long periods of time). This review describes the mechanisms of the angiogenic process and evaluates the recent data about antiangiogenic therapies in clinical trials.     

A practical prognostic index for inoperable non-small-cell lung cancer

Radical radiotherapy is widely used to treat inoperable non-small-cell lung cancer (NSCLC) although only a small number of patients benefit in the long run from this intensive treatment. There is a small proportion of long-term survivors who might derive advantage from even more aggressive radiotherapy combined with chemotherapy. In order to support optimal treatment selection we have carried out univariate and multivariate analyses of possible prognostic variables in the retrospective data of 502 NSCLC patients treated at one institute with external radiotherapy, both with curative and palliative intent. To obtain more accurate tools for a rational treatment decision, we identified, by using Cox's proportional-hazards model, the five most powerful determinants of overall survival and combined them to a prognostic index. On the basis of only the number of these risk factors (advanced stage, general or metastatic symptoms, poor performance status, anemia and tumor size of at least 7 cm), the patient falls into one of the six possible prognostic groups and these groups turned out to be identifiable as separate prognostic clusters. Thirty-one per cent of the patients have three or more risk factors and a median survival of 5–7 months compared with 18 months for patients without any non-favorable factor. Furthermore, the prognostic factors were so strong that multivariate analyses did not reveal the treatment selection to have any significant influence on survival. As each of the five variables have the advantage of being routinely available, our index is simple enough to be used in daily clinical practice. The clinical value of the prognostic index should be verified by using independent data.Abbreviation NSCLC non-small-cell lung cancer This study was supported financially by the Finnish Cancer Society and Medical Research Fund of Tampere University Hospital     

Endogenous secretory receptor for advanced glycation end products in non-small cell lung carcinoma

RATIONALE: The receptor for advanced glycation end products is a multiligand receptor that plays an important role in regulating the invasiveness and metastatic potential of cancer cells. A recently discovered novel splice variant, the endogenous secretory receptor for advanced glycation end products, mediates the receptor for advanced glycation end-product-associated cell responses by functioning as a decoy receptor. OBJECTIVES: To evaluate the expression pattern of endogenous secretory receptor for advanced glycation end products in non-small cell lung carcinoma, and analyze its impact on prognosis. METHODS: We performed immunohistochemical evaluation in 182 non-small cell lung carcinoma surgical specimens. The effect of an overexpressed receptor in cancer cell proliferation was also evaluated. MEASUREMENTS AND MAIN RESULTS: The endogenous secretory receptor for advanced glycation end-product expression in cytoplasm was reduced or absent in 137 of the 182 (75%) carcinomas in contrast to normal lung tissues. mRNA expression was also suppressed in cancer cells. Overexpression of the secretory receptor in lung cancer cell lines had an inhibitory effect on cell proliferation, suggesting the reduced receptor expression accelerated tumor growth. Among patients with low expression of the cytoplasmic secretory receptor, the overall survival rate was significantly lower than that of patients with normal expression (p = 0.0003). This association was most prominent in TNM stage I patients (p = 0.0001). In a multivariate analysis, endogenous secretory receptor immunoreactivity was an independent prognostic factor with a relative risk of 3.1. CONCLUSIONS: The cytoplasmic endogenous secretory receptor for advanced glycation end-product expression has the potential to be a prognostic factor for predicting the outcome of curative surgery in patients with non-small cell lung carcinoma.