The Expression Of Granulocyte Colony Stimulating Factor (G-CSF) In Non Small Cell Lung Cancer (NSCLC) And Its Clinicopathological Significance

Objective To examine G-CSF expression in human non-small cell lung cancer(NSCLC) as well as study the relationships between G-CSF expression and pathological character of NSCLC; And discus its Clinicopathological significance.Methods Specimens were obtained from 114 cases diagnosed pathologically as NSCLC with detailed clinical and pathological data in PLA General Hospital. Paraffin-embedded tissues from 114 cases of NSCLC who had under-gone radical tumor resection were examined for expression of G-CSF by SP immunohistochemical staining. Relationships were analyzed statistically between G-CSF expression and pathological feature, clinical manifestation, prognosis of patients with NSCLC. All the patients were retrospectively followed-up.Results 55of the 114 lung cancer specimens were found to have expression of G-CSF (55/114,48.25%) among which 41(41/54,75.93%) were large cell carcinoma, 9(9/30,30%) were adenocarcinoma and 5(5/30,16.67%) were squamous cell carcinoma. The positive was significantly correlated with infiltration of mass neutrophilic granulocyte, histological type, necrosis, differentiation, lymph node metastases, long distance metastases, recurrence, fever, peripheral blood neutruphil count and survival period (p<0.01). There were significant differences of leukocytosis level among different histological type (p<0.01). Logistic multi-factor analysis revealed that lymph nodes metastases and long distance metastases RR (Risk Ratio) in G-CSF positivegroup was 6.28 times and 5.24 times higher than that of G-CSF negative (p<0.01). There were remarkable differences of 5-year survival rates (0 and 8.05% respectively) and survival period (42 and 62 months respectively) between positive expression and negative group (p<0.01). But it wasn't significantly correlated with primary tumor size (p=0.1396) and TNM stage (staging) (p=0.0828).Conclusion NSCLC with G-CSF excretion are mainly large cell lung cancer. The expression of G-CSF might be responsible for the neutruphil count increase in peripheral blood and the patient' fever. The pathologic characteristic of these cases with the expression of G-CSF included poor differentiation, remarkable atypia, priminent necrosis;and infiltration of mass neutrophils or emperipolesis.these tumors usually are more aggressive in biological behavior and have a worse prognosis than those cases without G-CSF expression.