Immune function, telomerase, and angiogenesis in patients with primary, operable nonsmall cell lung carcinoma - Tumor size and lymph node status remain the most important prognostic features

BACKGROUND. Lung carcinoma usually is advanced at the time of presentation and frequently shows metastatic spread. In recent times, prognostic factors such as c-erbB-2 in patients with breast carcinoma have provided useful in formation and beneficial therapeutic targets. The objective of this study w as to evaluate angiogenesis, immune function, and telomerase expression in patients with nonsmall cell lung carcinoma (NSCLC) to determine their progn ostic significance. METHODS. Immunohistochemistry was used to evaluate the expression of human telomerase reverse transcriptase (hTERT; n = 115 patients), interleukin-2r (IL-2r; n = 40 patients), microvessel density (MVD; n = 81 patients), and v ascular endothelial growth factor (VEGF; n = 61 patients). Three-year survi val follow-up information was available for most patients, and a comprehens ive review of clinicopathologic features was carried out. RESULTS. Fifty percent of tumors showed nuclear staining for hTERT, 55% of tumors showed some degree of lymphocyte IL-2r expression, 33% of tumors wer e recorded with an MVD that was higher than average, and VEGF staining was detected in 85% of tumors. None of the parameters measured had an impact on Beaumont Hospital, Dublin, Ireland. survival. hTERT expression was correla ted with lymph node status. Lymph node status and tumor size were identifie d as independent prognostic factors. CONCLUSIONS. This study failed to identify a marker of prognosis for patien ts with Beaumont Hospital, Dublin, Ireland. NSCLC other than tumor size and lymph node status in this population. Telomerase expression was associated with metastases, raising the possibility that this enzyme is involved in t he metastatic process. Tumor cell VEGF expression was identified frequently : This growth factor may have potential as a target for antiangiogenic ther apy. Lung carcinoma typically is the result of large numbers of mutations. Further understanding of the biologic implications of these mutations will lead to the development of effective prognostic markers and treatments for patients with NSCLC. (C) 2001 American Cancer Society.