PROGNOSTIC IMPLICATIONS OF P-GLYCOPROTEIN, EPIDERMAL GROWTH-FACTOR RECEPTOR AND TRANSFORMING GROWTH-FACTOR-ALPHA - IMMUNOHISTOCHEMICAL EXPRESSION IN NON-SMALL-CELL LUNG-CANCER

The prognostic value of clinical and pathological factors in 97 patien ts (pts) with non-small cell lung cancer (NSCLC), were analyzed throug h immunohistochemical methods. The impact on response rate and surviva l of age, Karnofsky performance status (PS), sex, NSCLC subtype and gr ade, extent of disease, objective chemotherapy response, LDH values, m etastatic sites involved and immunohistochemical study of epidermal gr owth factor receptor (EGF-r), transforming growth factor alpha (TGF-al pha) and P-glycoprotein (Pgp) employing two monoclonal antibodies: C-2 19 and JSB-1, were analyzed. Median age was 61 years, seven pts were w omen. Histologically, 58 had squamous cell carcinoma, 28 adenocarcinom a and 11 large cell undifferentiated carcinoma. One patient had stage II, 35 stage IIIA, 19 stage IIIB and 42 stage IV. Six pts achieved com plete response, 18 partial response, 34 stable disease and 39 progress ive disease. EGF-r was positive in 30 cases, TGF-alpha in 51, C-219 Pg p in 13 and JSB-1 Pgp in 35 cases. The univariate analysis showed that 4 parameters had significant adverse effect on survival: non-responde rs, poor PS, abnormal LDH value and absence of EGF-r expression. On th e other hand, we found no correlation between TOP-alpha and EGF-r immu nostaining. But 22 pts expressed both autocrine markers and these pts had a worse median survival time. Multivariate analysis showed that th e only independent prognostic factor in predicting survival was Karnof sky performance status.