title: Serum levels of apoptosis biomarkers, survivin and TNF-alpha in nonsmall cell lung cancer.
abstract: BACKGROUND
  This study was conducted to investigate the prognostic role and the effects of chemotherapy on serum apoptosis biomarkers consisting of survivin and tumor necrosis factor alpha (TNF-alpha) in patients with advanced stage nonsmall cell lung cancer (NSCLC).
  
  
  METHODS
  Fifty-seven patients with newly diagnosed NSCLC were enrolled into study. Performance status was 0 or 1 in 47 patients and 2 in 10 patients. Thirty-two of them were no or less than 10% weight loss. Patients were treated with platinum-based chemotherapy. Serum levels of TNF-alpha and survivin were determined by enzyme-linked immunosorbent assay (ELISA) technique.
  
  
  RESULTS
  While serum survivin levels in patients were not significantly different from controls (p=0.321), serum TNF-alpha levels in patients were found significantly higher than in controls (p=0.029). We found that serum TNF-alpha levels were increased (p<0.001), whereas serum levels of survivin (p=0.025) were decreased by the chemotherapy effects. The changes of the TNF-alpha and survivin serum levels due to chemotherapy effect showed a significant negative correlation (r=-0.36 p=0.007). The increase of serum TNF-alpha levels was independent from chemotherapy response; however, the reduction of serum survivin levels was found only significant in the chemoresponsive group (p=0.039). While older age, weight loss and performance status yielded prognostic value, neither TNF-alpha nor survivin levels proved to be significant for survival.
  
  
  CONCLUSIONS
  Our findings suggest that the reduction in the serum survivin levels of advanced NSCLC patients after chemotherapy can be used as a predictor of response to the chemotherapy but not that of survival.
authors: Institute of Oncology, Istanbul University, Istanbul, Turkey. dygderin@yahoo.com
authors: Duygu
authors: D
authors: Derin
authors: Hilal Oguz
authors: HO
authors: Soydinç
authors: Nese
authors: N
authors: Guney
authors: Faruk
authors: F
authors: Tas
authors: Hakan
authors: H
authors: Camlica
authors: Derya
authors: D
authors: Duranyildiz
authors: Vildan
authors: V
authors: Yasasever
authors: Erkan
authors: E
authors: Topuz
mesh_terms: D000328:Adult; D000368:Aged; D017209:Apoptosis / Q000502:physiology*; D014408:Biomarkers, Tumor / Q000097:blood*; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood* / Q000188:drug therapy / Q000473:pathology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins; D008175:Lung Neoplasms / Q000097:blood* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008869:Microtubule-Associated Proteins / Q000097:blood*; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000097:blood*; D009367:Neoplasm Staging; D017671:Platinum Compounds / Q000627:therapeutic use; D011379:Prognosis; D012189:Retrospective Studies; D000077022:Survivin; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: C107489:BIRC5 protein, human; D014408:Biomarkers, Tumor; D051034:Inhibitor of Apoptosis Proteins; D008869:Microtubule-Associated Proteins; D009363:Neoplasm Proteins; D017671:Platinum Compounds; D000077022:Survivin; D014409:Tumor Necrosis Factor-alpha