NDLI: A biological staging model for operable non-small cell lungcancer

Content Provider	PubMed Central
Author	Cox, G. Jones, J. Andi, A. Waller, D. O'byrne, K.
Abstract	BACKGROUND—Currentlythe best prognostic index for operable non-small cell lung cancer(NSCLC) is the TNM staging system. Molecular biology holds the promiseof predicting outcome for the individual patient and identifying noveltherapeutic targets. Angiogenesis, matrix metalloproteinases (MMP)-2and -9, and the erb/HER type I tyrosine kinase receptors are allimplicated in the pathogenesis of NSCLC. METHODS—Aretrospective analysis of 167 patients with resected stage I-IIIaNSCLC and >60 days postoperative survival with a minimum follow up of2 years was undertaken. Immunohistochemical analysis was performed onparaffin embedded sections for the microvessel marker CD34, MMP-2 andMMP-9, EGFR, and c-erbB-2 to evaluate the relationships between andimpact on survival of these molecular markers. RESULTS—Tumour cellMMP-9 (HR 1.91 (1.23-2.97)), a high microvessel count (HR 1.97 (1.28-3.03)), and stage (stage II HR 1.44 (0.87-2.40), stage IIIa HR2.21 (1.31-3.74)) were independent prognostic factors. Patients with ahigh microvessel count and tumour cell MMP-9 expression had a worseoutcome than cases with only one (HR 1.68 (1.04-2.73)) or neither (HR4.43 (2.29-8.57)) of these markers. EGFR expression correlated withtumour cell MMP-9 expression (p<0.001). Immunoreactivity for both ofthese factors within the same tumour was associated with a poorprognosis (HR 2.22 (1.45-3.41)). CONCLUSION—Angiogenesis,EGFR, and MMP-9 expression provide prognostic information independentof TNM stage, allowing a more accurate outcome prediction for theindividual patient. The development of novel anti-angiogenic agents,EGFR targeted therapies, and MMP inhibitors suggests that targetspecific adjuvant treatments may become a therapeutic option inpatients with resected NSCLC.
Related Links	http://dx.doi.org/10.1136/thorax.56.7.561
Starting Page	561
File Format	PDF
ISSN	14683296
e-ISSN	14683296
Journal	Thorax
Issue Number	7
Volume Number	56
Language	English
Publisher	BMJ Group
Publisher Date	2001-07-01
Access Restriction	Open
Rights Holder	BMJ Group
Subject Keyword	Research in Higher Education
Content Type	Text
Resource Type	Article
Subject	Pulmonary and Respiratory Medicine

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