Neuroendocrine differentiation as an indicator of chemosensitivity and prognosis in nonsmall cell lung cancer.

Abstract

CONTEXT:

Nonsmall cell lung cancers with neuroendocrine differentiation (NSCLC-ND) may demonstrate biologic behavior intermediate between NSCLC and small cell lung cancer (SCLC) with impact on prognosis.

METHODS:

We analyzed 116 consecutive patients with Stage III and IV NSCLC who were diagnosed and treated between 2001 and 2006. Using immuno-histochemical staining for neuron-specific enolase (NSE), chromogranin A (ChrA), and synaptophysin (Syn), 29 (25%) NSCLC-ND were identified.

RESULTS:

Expression of NSE was present in 22.4%, ChrA in 15.5% and Syn in 14.8% of patients with NSCLC. Therapeutic response was significantly better in the NSCLC-ND group and specimens with > 30% neuroendocrine (NE)-differentiated tumor cells showed favourable therapeutic response (P < 0.05). Multivariate binary logistic regression showed that percentage of NE positive tumor cells was a significant independent prognostic factor associated with a favourable outcome. Receiver operating characteristic (ROC) curves and areas under ROC curves confirmed that percentage of NE-differentiated tumor cells could be useful prediction factor of therapeutic response. Moreover, according to percentage of NE-differentiated tumor cells, optimal cutoffs and related sensitivities and specificities were determined for each markers.

CONCLUSION:

Advanced-stage NSCLC with NE tumor cells are clinically less aggressive tumors. Percentage of NE-differentiated tumor cells identifies patients with favourable therapy response to paclitaxel-cisplatin.

• Authors: Marina Petrović, Dejan Baskić, Dragić Banković, Nevenka Ilić
• Journal: Biomarkers : biochemical indicators of exposure, response, and susceptibility to chemicals (Biomarkers) Vol. 16 Issue 4 Pg. 311-20 (Jun 2011) ISSN: 1366-5804 [Electronic] England
• PMID: 21595568 (Publication Type: Journal Article)

Chemical References

• Biomarkers, Tumor
• Chromogranin A
• Synaptophysin
• Phosphopyruvate Hydratase
• Paclitaxel
• Cisplatin

Topics

• Adult
• Aged
• Biomarkers, Tumor (analysis)
• Carcinoma, Non-Small-Cell Lung (drug therapy, pathology)
• Cell Differentiation
• Chromogranin A (analysis)
• Cisplatin (therapeutic use)
• Drug Resistance, Neoplasm
• Female
• Humans
• Male
• Middle Aged
• Neuroendocrine Cells (chemistry, pathology)
• Neuroendocrine Tumors (drug therapy, pathology)
• Paclitaxel (therapeutic use)
• Phosphopyruvate Hydratase (analysis)
• Prognosis
• Synaptophysin (analysis)
• Treatment Outcome