NEURAL CELL-ADHESION MOLECULE AND PROGNOSIS OF SURGICALLY RESECTED LUNG-CANCER

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.