TRANSFERRIN RECEPTOR EXPRESSION IN NONSMALL CELL LUNG-CANCER - HISTOPATHOLOGIC AND CLINICAL CORRELATES

Background. In the search for tumor-related antigens with survival-pre dictive value, previous studies have yielded varied conclusions regard ing the expression of one such antigen, the transferrin receptor in lu ng cancer. The goal of this study was to define the frequency of expre ssion of transferrin receptor in lung cancer specimens and gather prel iminary data regarding the prognostic value of this tumor-related anti gen. Methods. Tissue immunoreactivity was studied with a murine monocl onal antibody to transferrin receptor in patients with nonsmall cell l ung cancer who underwent surgical resection at the Medical Center Hosp ital of Vermont during the period from January, 1988, to May, 1991. Re sults. The study group consisted of 32 patients (21 males and 11 femal es) with an average follow-up length of 27 months (standard deviation of 16 months). There were 17 patients with adenocarcinoma, 14 with squ amous cell carcinoma, and 1 with large cell carcinoma. At the end of d ata accumulation, a total of 16 deaths had been recorded (8 with squam ous cell, 8 with adenocarcinoma). Normal lung tissue did not stain for transferrin receptor; however, 13 of 17 (76%) adenocarcinomas, 13 of 14 (93%) squamous cell carcinomas, and the 1 large cell carcinoma stai ned positively for transferrin receptor. Staining for transferrin rece ptor was graded according to pattern and intensity and categorized as absent-weak or strong. Survival analysis was performed to evaluate pat ient outcome based on a variety of clinical and experimentally determi ned characteristics. Groups based on N-status (NO vs. N1 + N2, P = 0.0 8), stage (Stage 1 vs. Stage 2 + 3, P = 0.13), age (younger than 60 vs . 60 years or older, P = 0.09), and transferrin receptor staining (abs ent-weak vs. strong, P = 0.14) achieved nearly significant differences in survival. Further analysis of the differences in survival for grou pings based on transferrin receptor staining found that these differen ces in survival reached significance for patients with larger tumors ( T2 or T3, P = 0.02). Conclusions. Transferrin receptor is expressed in the majority of lung cancers and the presence of transferrin receptor in nonsmall cell lung cancers may be an indicator of poorer prognosis in certain groups of patients.