title: Combined status of MUC1 mucin and surfactant apoprotein A expression can predict the outcome of patients with small-size lung adenocarcinoma.
abstract: OBJECTIVE
  Lung cancer is still a disease of high mortality, despite advanced diagnostic techniques. Here, we aim to report a unique method to predict the recurrence and outcome of patients with pulmonary adenocarcinomas.
  
  
  RESULTS
  Immunohistochemical expression of MUC1 mucin and surfactant apoprotein A (SP-A) was examined in 185 cases of surgically removed lung adenocarcinomas of non-bronchioloalveolar type smaller than 30 mm. Staining results were evaluated semiquantitatively, and the expression of MUC1 and SP-A was compared in each case. There were 140/185 (76%) cases showing MUC1 expression higher than SP-A expression (MUC1>SP-A), and 45/185 (24%) cases showing MUC1 expression lower than or equal to SP-A expression (MUC1<or =SP-A). Recurrence was observed in 24% (34/140) of the patients with a MUC1>SP-A pattern, but in 7% (3/45) of the patients with a MUC1< or =SP-A pattern after the median observation period of 41 months (1-99 months) (P < 0.01). The MUC1>SP-A group showed higher recurrence and worse survival than the MUC1<or =SP-A group by Kaplan-Meier's method (P < 0.01 and P < 0.005). Even in the patients with apparently favourable prognostic factors (well-differentiated adenocarcinoma or no lymph node metastasis), recurrence and survival were different between the two groups.
  
  
  CONCLUSIONS
  A high MUC1/SP-A ratio is strongly associated with a poor outcome in patients with small-size lung adenocarcinoma.
authors.affiliation: Division of Human Pathology, Department of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Tsutsumida
authors.forename: M
authors.initials: M
authors.lastname: Goto
authors.forename: S
authors.initials: S
authors.lastname: Kitajima
authors.forename: I
authors.initials: I
authors.lastname: Kubota
authors.forename: Y
authors.initials: Y
authors.lastname: Hirotsu
authors.forename: S
authors.initials: S
authors.lastname: Yonezawa
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001059:Apoproteins / Q000096:biosynthesis*; D014408:Biomarkers, Tumor / Q000032:analysis*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D018396:Mucin-1 / Q000096:biosynthesis*; D009364:Neoplasm Recurrence, Local / Q000378:metabolism; D011379:Prognosis; D037661:Pulmonary Surfactant-Associated Proteins / Q000096:biosynthesis*
chemical_list: D001059:Apoproteins; D014408:Biomarkers, Tumor; D018396:Mucin-1; D037661:Pulmonary Surfactant-Associated Proteins; C046616:pulmonary surfactant apoprotein