Peripheral airway cell marker expression in non-small cell lung carcinoma. Association with distinct clinicopathologic features.
Paraffin sections of 247 primary and metastatic non-small cell lung carcinomas, the corresponding non-neoplastic lungs, and 75 other specimens were examined by immunohistochemical procedures using a panel of antibodies against the specific products of peripheral airway cells: the major surfactant-associated protein and 10-kD Clara cell protein. Non-small cell lung carcinoma tumors most frequently positive for either peripheral airway cell marker were adenocarcinomas (41%), especially those with papillolepidic growth pattern (56%), followed by large cell carcinomas (25%), other adenocarcinomas (22%), and squamous cell carcinomas (16%). Immunoreactivity was mainly focal and the expression of the two peripheral airway cell markers was discordant. The incidence of marker expression was similar in metastatic and primary non-small cell lung carcinoma. Other organs and their tumors were negative, with few exceptions. Non-small cell lung carcinomas positive for peripheral airway cell markers were associated with younger age and less-intense smoking, and surfactant-associated protein reactivity was more common in women than in men. Peripheral airway cell markers were independent prognostic factors for survival and delayed development of metastases in patients with less-advanced disease. It is concluded that surfactant-associated protein and 10-kD Clara cell protein are specific markers for non-small cell lung carcinoma and peripheral airway cell differentiation and provide useful tools to study the pathogenesis, biology, and prognosis of non-small cell lung carcinoma.
National Cancer Institute-Navy Medical Oncology Branch, Naval Hospital, Bethesda, Maryland 20889-5105.
R I
RI
Linnoila
S M
SM
Jensen
S M
SM
Steinberg
J L
JL
Mulshine
J C
JC
Eggleston
A F
AF
Gazdar
D000375:Aging / Q000502:physiology; D015415:Biomarkers; D002289:Carcinoma, Non-Small-Cell Lung / Q000378:metabolism* / Q000401:mortality; D006651:Histocytochemistry / Q000379:methods; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008168:Lung / Q000378:metabolism; D008175:Lung Neoplasms / Q000378:metabolism* / Q000401:mortality; D011506:Proteins / Q000378:metabolism*; D011510:Proteolipids / Q000378:metabolism*; D037661:Pulmonary Surfactant-Associated Proteins; D011663:Pulmonary Surfactants / Q000378:metabolism*; D012137:Respiratory System / Q000378:metabolism*; D012680:Sensitivity and Specificity; D012907:Smoking; D013194:Staining and Labeling; D016019:Survival Analysis; D014598:Uteroglobin
D015415:Biomarkers; D011506:Proteins; D011510:Proteolipids; D037661:Pulmonary Surfactant-Associated Proteins; D011663:Pulmonary Surfactants; C556389:SCGB1A1 protein, human; D014598:Uteroglobin