title: EGR1 predicts PTEN and survival in patients with non-small-cell lung cancer.
abstract: OBJECTIVE
  The zinc finger transcription factor early growth response gene 1 (EGR1) is underexpressed in non-small-cell lung cancer (NSCLC) compared with normal lung. EGR1 expression has been linked to tumor suppression as a result of cell cycle arrest and apoptosis through regulation of tumor suppressor pathways including PTEN. For these reasons, we hypothesized that reduced levels of EGR1 would correlate with inferior outcome in patients with NSCLC.
  
  
  METHODS
  Patients who underwent surgical resection for NSCLC had RNA extracted from tumor tissue and EGR1 gene expression was quantified by real-time quantitative polymerase chain reaction. The levels of EGR1 expression were examined in relationship to patient characteristics, histology, tumor stage, PTEN expression, and overall and disease-free survival.
  
  
  RESULTS
  EGR1 expression strongly correlated with PTEN expression (P < .0001). No correlation of EGR1 with histology or stage was detected. Patients with high levels of EGR1 had better overall and disease-free survival compared with patients with low levels of EGR1 (P = .040 and P = .096, respectively). In a stratified log-rank test, low EGR1 expression was predictive of poor survival independent of tumor stage.
  
  
  CONCLUSIONS
  EGR1 gene expression predicts PTEN levels and survival after surgical resection of NSCLC. Consistent with its known tumor suppressor properties, lower levels of EGR1 are associated with poor outcome. Identification of patients with low EGR1 therefore may identify patients at high risk for disease recurrence and may also identify patients who have tumors resistant to therapy secondary to loss of pathways such as PTEN.
authors.affiliation: Thoracic Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, MRC3 E, Room 3056, 12902 Magnolia Dr, Tampa, FL 33612-9497, USA.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Ferraro
authors.forename: Gerold
authors.initials: G
authors.lastname: Bepler
authors.forename: Swati
authors.initials: S
authors.lastname: Sharma
authors.forename: Alan
authors.initials: A
authors.lastname: Cantor
authors.forename: Eric B
authors.initials: EB
authors.lastname: Haura
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor; D002289:Carcinoma, Non-Small-Cell Lung / Q000235:genetics* / Q000401:mortality / Q000473:pathology; D018572:Disease-Free Survival; D051765:Early Growth Response Transcription Factors; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D051741:Kruppel-Like Transcription Factors; D008175:Lung Neoplasms / Q000235:genetics* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D051059:PTEN Phosphohydrolase; D010744:Phosphoric Monoester Hydrolases / Q000378:metabolism*; D011237:Predictive Value of Tests; D020133:Reverse Transcriptase Polymerase Chain Reaction; D016019:Survival Analysis; D014157:Transcription Factors / Q000235:genetics*; D025521:Tumor Suppressor Proteins / Q000378:metabolism*; D015032:Zinc
chemical_list: D014408:Biomarkers, Tumor; D051765:Early Growth Response Transcription Factors; C098111:KLF10 protein, human; D051741:Kruppel-Like Transcription Factors; D014157:Transcription Factors; D025521:Tumor Suppressor Proteins; D010744:Phosphoric Monoester Hydrolases; D051059:PTEN Phosphohydrolase; C494929:PTEN protein, human; D015032:Zinc