title: Blood group antigen A and flow cytometric analysis in resected early-stage non-small cell lung cancer.
abstract: The loss of blood group antigen A on tumor tissue has been reported to be a strong adverse prognostic marker for patients with resected non-small cell lung cancer (NSCLC). Results have varied with respect to the prognostic significance of flow cytometric data. We sought to confirm the prognostic significance of blood group antigen A loss and flow cytometry in a large cohort of patients with early-stage NSCLC. Two hundred and sixty patients with surgically resected stage I (n = 193) and II (n = 67) NSCLC with at least a 5-year follow-up were identified. Using paraffin-embedded primary tumor, immunohistochemical stains for blood group antigen A were performed on 90 patients with blood type A or AB. The DNA index and percentage of cells in S phase were successfully obtained on 188 and 152 patients, respectively. The median survival time of the patients with primary tumors negative for blood group antigen A was 38 months (n = 36), compared with 98 months (n = 54) for those with antigen A-positive tumors (P < 0.01). The median disease-free survival times for antigen A-negative and -positive tumors were 26 months and 98 months, respectively (P < h 0.01). The median survival time of the patients with aneuploid tumors was 51 months (n = 131), compared with 50 months (n = 57) for those with diploid tumors (P = 0.42). The median survival time of the patients with S phase >8% was 44 months (n = 105), compared with 60 months (n = 47) for those with S phase </=8% (P = 0.18). Multivariate analysis showed that the loss of antigen A, higher N and T stages, and the presence of mucin predicted for poorer disease-free and overall survival. In the subgroup of patients with blood group A or AB, the loss of A antigen was the most powerful negative predictor of survival. Aneuploidy and percentage of cells in S phase were not of prognostic significance in this group of patients with resected stage I and II NSCLC. The value of blood group antigen A analysis needs to be evaluated in larger and prospective studies of early-stage NSCLC. Alteration of blood group antigen cell surface expression may represent an important marker for more aggressive biological and metastatic behavior in NSCLC.
authors.affiliation: Department of Medicine, Veterans Affairs Medical Center and State University of New York Health Science Center, Syracuse, New York 13210, USA.
authors.forename: S L
authors.initials: SL
authors.lastname: Graziano
authors.forename: A H
authors.initials: AH
authors.lastname: Tatum
authors.forename: N J
authors.initials: NJ
authors.lastname: Gonchoroff
authors.forename: N B
authors.initials: NB
authors.lastname: Newman
authors.forename: L J
authors.initials: LJ
authors.lastname: Kohman
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000097:blood; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood* / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016019:Survival Analysis
chemical_list: D000017:ABO Blood-Group System; D000951:Antigens, Neoplasm