A Biological Risk Model For Stage Ⅰ Completely Resected Adenocarcinoma Of Lung

Objective:The standard treatment of patients with stage non-small cell lung cancer is resection of the primary tumor;however,the 5 years survival rate of patients with adenocarcinoma of lung is only 61%.The different and unpredictable outcomes in stageⅠadenocarcinoma of lung patients requires urgent research concerning the biological pathway of this neoplasm.This study evaluates a panel of molecular biological markers in patients with stageⅠresected adenocarcinoma of lung to determine the prognostic value of each marker and to creat a molecular biological risk model.Mehnods:Pathologic specimens were collected from 68 consecutive patients after resection for stageⅠadenocarcinoma of lung at a single institution,with mean follow-up of 53 months.A panel of 7 molecular markers was chosen for immunohistochemical analysis of the primary tumor on the basis of differing oncogenic mechanisms.1,Self-sufficiency for growth pathway(Ki-67,Her-2); 2,Insensitivity to growth inhibition(p16);3,Resistance to apoptosis(P53); 4,Sustained angiogenesis(VEGF);5,Invasion and Metastasis(MMP-9,CD44v6)。The results were analysed by SPSS13.0 statistic software.The univariate and multivariate analyses were applied to evaluate the prognostic factors.Kaplan-Meier estimates of survival were calculated for clinical variables and biological markers using Cox's model for multivariate analysis.All tests were performed at the 0.05 level of significances.Result:Multivariable analysis demonstrated signifcantly elevated risk for the following molecular markers:p53(RR=3.228,p=0.010);MMP-9(RR=2.071, p=0.033);VEGF(RR=2.577,p=0.025).Conclusions:Our data do not support a relevant prognostic role for Her-2,P16, Ki-67 or CD44v6 molecular biologic markers in stageⅠadenocarcinoma of lung. Other three markers were an independent predictive factor of poor outcome, representing oncogenic mechanisms:resistance to apoptosis(p53);sustained angiogenesis(VEGF);invasion and Metastasis(MMP-9).This study demonstrates the validity of this molecular biologic risk model in patients with stageⅠadenocarcinoma of lung.Pathological stage was confirmed as the prognostic factor in the univariate analysis,but was denied in the.