Prognostic Factors for Stage I Non Small Cell Lung Cancer: A Single Institution Experience.
Francesca Franzi, Andrea Imperatori, Nicola Rotolo, Lorenzo Dominioni, Carlo Capella, Fausto Sessa. University of Insubria, Varese, Italy; Multimedica IRCCS, Milan, Italy
Background: The 5-years survival rate of patients with stage I non-small cell lung cancer (NSCLC) ranges greatly from 50% to 90%. The aim of this single Centre study was to evaluate the expression and the prognostic significance of some biological markers in resected stage I NSCLC patients.
Design: The expression of p53, Ki-67, ERCC-1 and TTF-1 was immunohistochemically analyzed in 157 resected stage I NSCLC, according to the 7th ed. TNM classification, (79 adenocarcinomas (AC); 61 squamous cell carcinomas (SQC); 11 bronchioloalveolar carcinoma (BAC);4 large cell carcinomas; 2 adenosquamous carcinomas); the median follow-up was 60 months. TTF-1 immunoreactivity was documented by using the commercially available clones, 8G7G3/1 and SPT24. Univariate and multivariate analysis was performed for clinico-pathological and immunohistochemical parameters.
Results: The 5-year overall survival was 49,6%. The overexpression of p53 was significantly more frequent in males and in SQC patients and was associated with high tumor grade and high Ki-67 proliferative activity. A significant correlation was also shown between the high expression of Ki-67 and high tumor grade. ERCC-1 was detected in 50% of NSCLC patients with a significantly higher frequency in SQC; moreover, ERCC-1 expression was correlated with high Ki-67 proliferative activity. TTF-1 expression was significantly greater in AC and in BAC. The SPT24 antibody detected a significantly higher number of AC than the 8G7G3/1 clone (p=0.0009). TTF-1 expression was significantly inversely correlated with Ki-67 proliferative activity, p53 overexpression and with ERCC-1 expression. TTF1 positive immunoreactivity correlated with higher tumour differentiation and with better prognosis. The factors significantly correlated to better survival at the univariate analysis were: stage IA, low p53 protein expression and low Ki-67; at multivariate analysis, only stage IA and low p53 protein expression were independent favorable prognostic factors.
Conclusions: This study confirms that in early stage NSCLC pathological stage IA and a low p53 expression are independent favorable prognostic factors. We also demostrated a relevant prognostic role for Ki-67. TTF1 expression might have a slight prognostic implication based on its correlation with better tumour differentiation, low Ki-67 proliferative activity and tendency for better survival. In addition we showed that the SPT24 antibody is more sensitive than the 8G7G3/1 clone for labeling lung adenocarcinomas.
Tuesday, March 1, 2011 1:00 PM
Poster Session IV # 269, Tuesday Afternoon