In this study, we investigated the prognostic value of HER2/neu, p53, and
vascular endothelial growth factor in early stage conventional
adenocarcinoma and
bronchioloalveolar carcinoma of the lung. We studied 100 patients and consisted of 50 cases with conventional
adenocarcinoma and 50 cases with
bronchioloalveolar carcinoma (32 nonmucinous and 18 mucinous subtypes). Representative sections were immunostained for HER2/neu, p53, and
vascular endothelial growth factor. Positivity was scored quantitatively by three observers and correlated with multiple prognostic parameters including survival. In the conventional
adenocarcinoma, HER2/neu, p53, and
vascular endothelial growth factor were expressed in 19/50 (38%), 32/50 (64%), 33/50 (66%), respectively. In this group, p53 showed a significant correlation with recurrence while
vascular endothelial growth factor correlated with angiolymphatic invasion (P < 0.05). HER2/neu, p53, and
vascular endothelial growth factor expression was associated with significantly shorter survival (log rank, P < 0.05). Patient whose
tumors coexpressed both p53 and HER2/neu had the worst outcome. In the
bronchioloalveolar carcinoma, HER2/neu, p53, and
vascular endothelial growth factor were expressed in 9/50 (18%), 3/50 (6%) and 12/50 (24%), respectively which was significantly less than in conventional
adenocarcinoma (P < 0.05). HER2/neu positivity showed a significant correlation with shorter survival (log rank, P < 0.05) in nonmucinous type. In conclusion,
vascular endothelial growth factor was associated with angiolymphatic invasion and poor prognosis in conventional
adenocarcinoma. Also, in conventional
adenocarcinoma, p53, and HER2/neu expression appeared to be poor prognostic markers, while in
bronchioloalveolar carcinoma, only HER2/neu was associated with a poorer prognosis. This immunostaining pattern suggests that conventional
adenocarcinoma has different molecular abnormalities than
bronchioloalveolar carcinoma.