High serum concentrations of Sialyl Lewisx predict multilevel N2 disease in non-small-cell lung cancer.
BACKGROUND
The purpose of this study was to analyze the clinical significance of serum Sialyl Lewisx (SLX) concentrations as a predictor of N2 disease in patients with non-small-cell lung cancer.


METHODS
The study included 272 patients with non-small-cell lung cancer who underwent pulmonary resection in our institution between January 1998 and December 2003. Of 272 patients, the serum concentrations of SLX were measured by using a commercially available radioimmunoassay kit.


RESULTS
The 5-year survival rates of patients with concentrations of SLX > 38 U/mL and those with lower concentrations were 32% and 69%, respectively (P < .0001). The median serum concentration of SLX in patients with multilevel N2 or N3, single-level N2, and N0/1 disease were 44, 30, and 27 U/mL, respectively. The concentrations of serum SLX in patients with multilevel N2 disease were significantly higher than those in patients with single-level N2 or those with N0/1 disease (Mann-Whitney U-test; P < .0001). Although the sensitivity of SLX for identifying patients with non-small-cell lung cancer was only 24% in all patients, the sensitivity of SLX increased as the N-factor increased; the sensitivity of N0/1 disease was 15%, that of single-level N2 disease was 22%, and that of multilevel N2 or N3 disease was 71%.


CONCLUSIONS
High serum concentrations of SLX predicted multilevel N2 disease and the associated poor outcome. Although the sensitivity of serum SLX is not acceptable for use as a screening tumor marker, we suggest that the serum concentration of SLX is useful as a staging marker to determine the strategy of treatment.
Mizuguchi
Shinjiro
S
Department of Thoracic Surgery, Osaka City University Medical School, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan. m1293795@misc.med.osaka-cu.ac.jp
Inoue
Kiyotoshi
K
Iwata
Takashi
T
Nishida
Tatsuya
T
Izumi
Nobuhiro
N
Tsukioka
Takuma
T
Nishiyama
Noritoshi
N
Uenishi
Takahiro
T
Suehiro
Shigefumi
S
D000230:Adenocarcinoma / Q000097:blood* / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood* / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007983:Lewis Blood Group Antigens; D008175:Lung Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009844:Oligosaccharides / Q000097:blood*; D011379:Prognosis; D012189:Retrospective Studies; D000080506:Sialyl Lewis X Antigen; D015996:Survival Rate; D016896:Treatment Outcome
D007983:Lewis Blood Group Antigens; D009844:Oligosaccharides; D000080506:Sialyl Lewis X Antigen