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NSCLC tumor markers linked to decreased overall survival
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Tumor markers of non-small cell lung cancer found in histologically negative lymph nodes using immunochemistry were associated with a decreased overall survival, according to recent research.
“Our findings suggest that consideration may be given to routinely staining for cytokeratin markers in histologically negative [lymph nodes] to look for [occult micrometastases],” Linda W. Martin, MD, MPH, from the Department of Surgery and Division of Thoracic Surgery at University of Maryland Medical School in Baltimore, and colleagues wrote in their study. “Treatment decisions on the basis of these findings remain a complex issue.”
Martin and colleagues analyzed the primary tumor and lymph nodes of 502 patients who were suspected to have non-small cell lung cancer (NSCLC) clinical stage I (T1-2N0M0), according to the abstract. The tumor and lymph nodes underwent real-time reverse transcriptase polymerase chain reaction (RT-PCR) to detect carcinoembryonic antigen and immunohistochemistry (IHC) for cytokeratin to detect occult micrometastases.
Of the 502 patients enrolled, 498 patients underwent surgical staging, and 304 patients (61%) had pathologic stage I NSCLC, with 56% of patients having adenocarcinoma, 34% having squamous cell carcinoma and 10% with another histology, according to the abstract. Lymph nodes that underwent IHC testing (298 patients) showed positive results for 41 patients (14%) with 42% of positive results in N1 position and 58% of results in N2 position. Although patients with IHC positive results in the N2 position showed significantly worse survival rates (HR = 2.04; P = .017), Martin and colleagues did not find a positive correlation between an IHC positive result and overall or disease-free survival.
Regarding RT-PCR results, there were 176 of 256 patients (69%) with lymph nodes that showed positive results, with 52% in the N1 position and 48% in the N2 position, according to the abstract. Martin and colleagues noted that there was no positive correlation between PCR-positive results and overall or disease-free survival. – by Jeff Craven
Disclosure: Martin, Burstein, Dragnev, Crawford, Graziano, Vaena, Edelman, Peterson, Freter, Shea and Bartlett received grants from the National Cancer Institute of the National Institutes of Health.
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