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Rivista di Chirurgia Cardiaca, Vascolare e Toracica

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Periodicità: Bimestrale

ISSN 0021-9509

Online ISSN 1827-191X


The Journal of Cardiovascular Surgery 2002 Agosto;43(4):545-8



Biological markers in non-small cell lung cancer. Retrospective study of 10 year follow-up after surgery

Carbognani P. 1, Tincani G. 1, Crafa P. 2, Sansebastiano G. 3, Pazzini L. 1, Zoni R. 3, Bobbio A. 1, Rusca M. 1

1 Depart­ment of Tho­racic and Vas­cular Sur­gery
2 Depart­ment of ­Pathology
3 Depart­ment of ­Hygiene
Uni­ver­sity of ­Parma, ­Parma, ­Italy

Back­ground. The bio­log­ical ­markers in non-­small ­cell ­lung ­cancer (­NSCLC) ­have ­been ­widely ­studied and encour­aging ­results ­have ­shown ­that prod­ucts of ­some onco­genes and ­other molec­ular ­markers can pre­dict the aggres­sive­ness of the dis­ease and the out­come of the ­patients.
­Methods. To ­verify the reli­ability of ­these prog­nostic ­markers we ­have ­studied ret­ro­spec­tively the expres­sion of c-­erbB-2 and 67Ki (­growth reg­u­la­tion), p53 (cell ­cycle reg­u­la­tion and apop­tosis), bcl-2 (apop­tosis) and CD31 and CD34 (angio­gen­esis) in 78 ­patients oper­ated on for ­NSCLC ­with cura­tive ­intent ­between Jan­uary 1987 and ­December 1988 and fol­lowed up for 10 ­years. For the deter­mi­na­tion of the bio­log­ical ­markers we ­have ­used the ABC (­Avidin-­Biotin-Per­ox­i­dase com­plex) immu­no­his­to­chem­ical ­method. The Cox regres­sion ­model was ­used for the uni­var­iate and mul­ti­var­iate anal­ysis.
­Results. Nine­teen ­patients (24%) ­were ­alive ­after 10 ­years and 59 (76%) ­died. The uni­var­iate anal­ysis of the rela­tion­ship ­between the 10-year sur­vival and the expres­sion of the ­markers was sig­nif­i­cant ­only for p53 (p=0.0097). Strat­i­fying the ­patients ­according to the 3 his­to­log­ical sub­types (squa­mous ­cell car­ci­noma, aden­o­car­cinoma and ­large ­cell undif­fer­en­tiated car­ci­noma) the cor­re­la­tion ­between ­markers and sur­vival ­pointed out ­that the ­only sig­nif­i­cant one was p53 (p=0.0459) in aden­o­car­cinoma. In the ­same way con­sid­ering the ­stages p53 was sig­nif­i­cant in ­stage ­IIIa (p=0.0357). The mul­ti­var­iate anal­ysis empha­sized ­that p53 was the ­only sig­nif­i­cant ­marker ­with ­respect to the 10-­year sur­vival (p=0.0091). Exam­ining the his­to­log­ical ­groups sig­nif­i­cant was ­only p53 in aden­o­car­cinoma (p=0.0192) and in ­large ­cell undif­fer­en­tiated car­ci­nomas (p=0.0290). ­This ­marker is ­also sig­nif­i­cant in path­o­logical ­stage II (p=0.0271) and ­IIIa (p=0.0402). ­Apart ­from his­tology and ­staging the 10-­year sur­vival was 33% for p53 neg­a­tive ­versus 10% for p53 pos­i­tive. In ­patients ­with aden­o­car­cinoma the 10-­year sur­vival was 40% for p53 neg­a­tive and 6% for p53 pos­i­tive.
Con­clu­sions. In con­clu­sion our ­results empha­size the impor­tance of p53 as a prog­nostic ­factor in 10-­year sur­vival in ­patients ­with aden­o­car­cinoma and in ­stage II and ­IIIa.

lingua: Inglese


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