THE PROGNOSTIC-SIGNIFICANCE OF NEUROENDOCRINE MARKERS AND CARCINOEMBRYONIC ANTIGEN IN PATIENTS WITH RESECTED STAGE-I AND STAGE-II NONSMALL CELL LUNG-CANCER
Sl. Graziano et al., THE PROGNOSTIC-SIGNIFICANCE OF NEUROENDOCRINE MARKERS AND CARCINOEMBRYONIC ANTIGEN IN PATIENTS WITH RESECTED STAGE-I AND STAGE-II NONSMALL CELL LUNG-CANCER, Cancer research, 54(11), 1994, pp. 2908-2913
Non-small cell lung cancer with neuroendocrine differentiation may rep
resent a subset of patients with a more aggressive (like small cell lu
ng cancer) or less aggressive (like carcinoid) biological behavior. To
investigate their prognostic significance, immunohistochemical stains
for 4 neuroendocrine markers (neuron-specific enolase, chromogranin A
, Leu-7, and synaptophysin) and carcinoembryonic antigen (CEA) were st
udied in 260 patients with surgically resected stage I and II non-smal
l cell lung cancer. The following percentages of cases were positive f
or each marker: neuron-specific enolase, 70.0%; chromogranin A, 14.2%;
Leu-7, 7.7%; synaptophysin, 11.2%; and CEA 68.5%. Sixty-one (23.5%) w
ere positive for greater than or equal to 2 neuroendocrine markers. Wh
en compared to adenocarcinoma, squamous cell carcinoma displayed lower
positivity for CEA and greater than or equal to 2 neuroendocrine mark
ers. There was no significant difference in stage, site of relapse (di
stant versus local), disease-free, or overall survival for each marker
individually or for those with greater than or equal to 2 neuroendocr
ine markers. Multivariate analysis showed that higher nodal stage (N-1
versus N-0), tumor stage (T-2 versus T-1), older age, and the presenc
e of mucin predicted for poorer overall survival. Neuroendocrine marke
rs and CEA were not of prognostic significance in this group of patien
ts with resected stage I and II non-small cell lung cancer.