prognostic significance of proliferative factors, angiogenesis and matrix metalloproteinase in non small cell lung carcinoma

ABSTRACT

The outcome of surgical treatment of non small cell lung carcinoma [NSCLC] remains poor. In many patients the biological behavior of NSCLC does not follow a definite pattern, and can not be accurately predicted before treatment. Thus, the proliferative potential of tumor cells, angiogenesis and matrix metalloproteinase [MMP] are an important prognostic factors. In the present study, expression of cyclin D1, CD34, MMP-2 and AgNORs count was estimated in a group of 80 surgically resected NSCLC using immunohistochemistry. The results were compared with clinicopathological parameters including patients' survival 41 cases [51.3%] revealed positive immunoreactivity for cyclin D1. Cyclin D1 overexpression is significantly higher [<0.05] in patients with lymph node metastasis [63.3% versus 15%], and with advanced pathological stages [stage I, 12.5%, II 37.5%, III 60% and IV 86.7%]. Patients with cyclin D1 positive immanoreactivity revealed a significantly shorter overall survival than patients with negativity. There is no significant correlation [p > 0.05] between CD34 score and histological type and grade, while there is significant positive correlation [p < 0.05] between high CD34 score and lymph node metastasis, distant metastasis, tumor stage and shorter over survival. No significant correlations [p > 0.05] were found between MMP-2 expression and histological type, grade and lymph node metastasis. In contrast the intensity of MMP-2 staining in tumor cells correlated significantly [p < 0.05] with tumor stage, and distant metastasis. Overall survival was shorter in patient with MMP-2 expression, although the difference does not reach statistical significant AgNORs count was found to correlate significantly [p < 0.05] with tumor grade, and the size, shape and distribution pattern was found to show a characteristic difference between non-neoplastic and neoplastic lesions. In conclusion, an overexpression of cyclin D1, angiogenesis, expression of MMP-2 and high AgNORs count are a poor prognostic factors for NSCLC, also MMP-2 and AgNORs can be used to differentiate between non-neoplastic and neoplastic lung lesions