Jl. Pujol et al., NEURAL CELL-ADHESION MOLECULE AND PROGNOSIS OF SURGICALLY RESECTED LUNG-CANCER, The American review of respiratory disease, 148(4), 1993, pp. 1071-1075
The prognostic significance of the expression of neural cell adhesion
molecule (NCAM), a neuroendocrine antigen in lung cancer, was analyzed
by an indirect immunoperoxidase method in 97 surgically treated patie
nts. Reactivity of MOC-1 and S-L 11.14, both cluster-1 monoclonal anti
bodies directed against NCAM, was positive in all nine small-cell lung
cancers and in 16 of 88 (18%) non-small-cell lung cancers. For the la
tter group, this expression demonstrated a phenotypic heterogeneity th
at was mainly observed in poorly differentiated squamous cell carcinom
as and in stage N2 non-small-cell lung cancers. Patients with NCAM-pos
itive non-small-cell lung cancer proved to have a shorter survival tha
n those with NCAM-negative disease. In Cox's model for multivariate an
alysis, nodal status and histology were the main independent determina
nts of prognosis. We therefore concluded that NCAM expression in non-s
mall-cell lung cancer is correlated to nodal status and that it indica
tes a poor prognosis. These findings confirm that the diversification
of lung cancer phenotype leads to tumor progression and brings a negat
ive prognosis to surgically resected non-small-cell lung cancer. Howev
er, nodal status remains the most important prognostic variable, sugge
sting that NCAM expression is only one of numerous biological events t
hat promote tumor progression.