LOSS OF ALPHA-V INTEGRIN EXPRESSION AND RECURRENCE IN NODE-NEGATIVE LUNG-CARCINOMA

Background. Despite ''curative'' resection, metastases develop in many patients with node-negative (NO) nonsmall cell lung carcinoma. Altern ative biologic markers for this tumor would be useful. Integrins are c ell adhesion molecules that are thought to be important in tumor progr ession, and expression of these molecules previously has been shown to be altered in non-small cell lung carcinoma. We evaluated alterations in integrin expression and clinical outcome. Methods. Immunohistochem ical staining of tumor specimens was performed, and clinical data were reviewed retrospectively. Results. Data were complete for 42 patients . Half of all patients (21/42) and 9 of 26 patients with negative node s experienced tumor recurrence during follow-up. Neither histologic ty pe nor tumor differentiation status correlated with recurrence. Howeve r, loss of the alpha v integrin subunit was associated significantly w ith recurrence in the NO group. Seventy-five percent of patients with negative nodes who exhibited recurrence lost alpha v expression, compa red with only 10% of patients with negative nodes who did not exhibit recurrence (p = .0.012). Alterations of other integrin subunits did no t correlate significantly with prognostic follow-up variables. Conclus ions. Loss of alpha v expression may serve as a marker for patients wi th node-negative non-small cell lung carcinoma who are at high risk fo r recurrence, potentially directing additional therapies. (C) 1997 by The Society of Thoracic Surgeons.