Molecular biologic substaging of stage I lung cancer according to gender and histology

Background. This study is designed to assess molecular biologic substaging according to gender and histology in patients with stage I non-small cell l ung cancer (NSCLC). Methods. Pathologic specimens were collected from 408 consecutive patients after complete resection for stage I NSCLC, with follow-up of at least 5 ye ars. A panel of nine molecular markers was chosen for immunohistochemical a nalysis of the tumor recessive oncogenes p53 and bcI-2, the protooncogene e rbB-2, KI-67 proliferation index, retinoblastoma oncogene (Rb), epidermal g rowth factor receptor (EGFr), angiogenesis factor viii, sialyl-Tn antigen ( STN), and CD-44. Cox proportional hazards regression analysis was used to c onstruct a risk model for cancer-specific survival according to marker stat us, gender, and histologic subtype. Results. Among men, the only molecular marker associated with decreased can cer-specific survival is erbB-2; among women, there are four markers: p53, Rb, CD-44, and factor viii, Among patients with squamous cell carcinoma the only molecular marker associated with decreased cancer-specific survival i s erbB-2; among patients with adenocarcinoma (AC), there are three markers: p53, CD-44, and factor viii. Multivariable analysis of interactions among molecular markers, gender, and histology demonstrates two important relatio nships (hazard. ratio): p53+/women (2.269) and CD-44+/AC (2.266). Conclusions. Molecular biologic substaging of patients with stage I NSCLC d emonstrates differential cancer-specific survival according to marker expre ssion, gender, and histologic subtype.