title: Immunohistochemical evidence that P-glycoprotein in non-small cell lung cancers is associated with shorter survival.
abstract: The expression of P-glycoprotein in 159 non-small cell lung cancers was immunohistochemically examined using a monoclonal antibody (MoAb C219). A total of 93 (60%) cancers were found to be positive for P-glycoprotein. The 5-year survival rates of patients with P-glycoprotein (P-gp+) and those without P-glycoprotein (P-gp-) were 47.6% and 73.6%, respectively (P < 0.05). According to a univariate analysis, P-gp+ was associated with a poor prognosis for males, those with stage I cancer, those who underwent complete resection, and those with adenocarcinoma or squamous cell carcinoma. A multivariate study using the Cox regression analysis indicated that the expression of P-glycoprotein is useful for predicting the prognosis. Among 24 patients who underwent complete resection and postoperative adjuvant chemotherapy, 18 were P-gp+ and the remaining 6 were P-gp-. Of the 18 with P-gp+ cancer, 11 relapsed and 9 died from tumor-related causes, while the other 7 remain free from tumor recurrence; however, all with P-gp- cancer are alive without recurrence. These observations suggest a bias toward a shorter survival for patients with P-gp+ cancer because P-glycoprotein may be associated with chemoresistance. Thus, detection of the expression of P-glycoprotein will aid in planning appropriate adjuvant chemotherapy for patients with non-small cell lung cancer.
authors.affiliation: Department of Surgery II, Faculty of Medicine, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Yokoyama
authors.forename: T
authors.initials: T
authors.lastname: Ishida
authors.forename: K
authors.initials: K
authors.lastname: Sugio
authors.forename: T
authors.initials: T
authors.lastname: Inoue
authors.forename: K
authors.initials: K
authors.lastname: Sugimachi
mesh_terms: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000032:analysis*; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D015996:Survival Rate
chemical_list: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D014408:Biomarkers, Tumor