title: Prognostic significance of gelsolin expression level and variability in non-small cell lung cancer.
abstract: BACKGROUND
  Gelsolin is an actin-binding protein that mediates cellular motility and maintains the integrity of cytoskeletal structure. Diminished expression of gelsolin has been observed in human cancer cell lines and tumors. Studies of the prognostic effect of gelsolin expression (GE) in non-small cell lung cancer (NSCLC) are rare and results are inconsistent to date. The present study used immunohistochemistry to evaluate the prognostic effect of gelsolin expression in 155 patients with resectable NSCLC.
  
  
  METHODS
  Detection of gelsolin in tumor cells was performed by immunohistochemistry, and two approaches to classification were used to describe expression: expression level (negative, reduced or high) and expression uniformity (uniform or variable). Expression level was determined by a weighted index of intensity of staining (i.e., overall tendency) in the specimen. Expression uniformity was based on the presence or absence of variability in immunostaining within the tumor section. Chi-square test, student t-test, Cox proportional hazards regression and Kaplan-Meier survival analysis were used in data analyses.
  
  
  RESULTS
  After controlling for covariates, high level gelsolin expression was significantly associated with poor survival compared with negative gelsolin expression in NSCLC, and this adverse prognostic effect was specific to patients with stage II tumors and for patients with squamous cell carcinomas. Similarly, variable gelsolin expression was significantly associated with poor survival compared with uniform gelsolin expression and this adverse prognostic effect was also specific to patients with stage II tumors and for patients with squamous cell carcinomas.
  
  
  CONCLUSIONS
  High level gelsolin expression and variable gelsolin expression are adverse prognostic factors for NSCLC in this study, which might manifest the high motility and heterogeneity of tumor cells, two distinguishing characteristics for tumors with potentially enhanced invasive and dissemination capabilities.
authors.affiliation: Division of Cancer Prevention and Population Sciences, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA. jun.yang@roswellpark.org
authors.forename: Jun
authors.initials: J
authors.lastname: Yang
authors.forename: Dongfeng
authors.initials: D
authors.lastname: Tan
authors.forename: Harold L
authors.initials: HL
authors.lastname: Asch
authors.forename: Helen
authors.initials: H
authors.lastname: Swede
authors.forename: Gerold
authors.initials: G
authors.lastname: Bepler
authors.forename: Joseph
authors.initials: J
authors.lastname: Geradts
authors.forename: Kirsten B
authors.initials: KB
authors.lastname: Moysich
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000235:genetics* / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D018260:Gelsolin / Q000032:analysis / Q000096:biosynthesis*; D020869:Gene Expression Profiling; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000235:genetics* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis
chemical_list: D018260:Gelsolin