Erythropoietin and erythropoietin receptor coexpression is associated with poor survival in stage I non-small cell lung cancer.
OBJECTIVE
This study was designed to evaluate the prognostic effect of erythropoietin (EPO) and EPO receptor (EPO-R) expression in stage I non-small cell lung cancer (NSCLC) patients.


METHODS
EPO and EPO-R expression in 158 tumor samples from resected stage I NSCLC was evaluated using immunohistochemistry and tissue array technology.


RESULTS
EPO-R and EPO were highly expressed in 20.9% and 35.4% of tumors, respectively. High EPO-R expression compared with negative or low-level expression was associated with a poor 5-year disease-specific survival (60.6% versus 80.8%; P = 0.01, log-rank test). High EPO expression compared with negative and low-level expression was associated with a trend toward a poor 5-year disease-specific survival (69.6% versus 80.4%; P = 0.13, log-rank test). A high level of EPO-R and EPO coexpression was associated with a poor 5-year disease-specific survival compared with other groups of patients (50.0% versus 80.0% survival at the end of follow-up; P = 0.005, log-rank test). In multivariate analysis for disease-specific survival, high-level EPO-R and EPO coexpression was an independent prognostic factor for disease-specific survival (hazard ratio, 2.214; 95% confidence interval, 1.012-4.848; P = 0.046).


CONCLUSIONS
These results establish the pejorative prognostic value of EPO and EPO-R expression in early-stage resected NSCLC and suggest a potential paracrine and/or autocrine role of endogenous EPO in NSCLC aggressiveness.
Saintigny
Pierre
P
Service d'Oncologie Médicale, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, Université Paris 13, France. pierre.saintigny@avc.aphp.fr
Besse
Benjamin
B
Callard
Patrice
P
Vergnaud
Anne-Claire
AC
Czernichow
Sébastien
S
Colombat
Magali
M
Girard
Philippe
P
Validire
Pierre
P
Breau
Jean-Luc
JL
Bernaudin
Jean-François
JF
Soria
Jean-Charles
JC
D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000737:chemistry / Q000401:mortality* / Q000473:pathology; D004921:Erythropoietin / Q000009:adverse effects / Q000032:analysis*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000737:chemistry / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D017467:Receptors, Erythropoietin / Q000032:analysis*; D011994:Recombinant Proteins; D046888:Tissue Array Analysis
D017467:Receptors, Erythropoietin; D011994:Recombinant Proteins; D004921:Erythropoietin