title: Overexpression of phospho-eIF4E is associated with survival through AKT pathway in non-small cell lung cancer.
abstract: OBJECTIVE
  The eukaryotic translation initiation factor complex 4E (eIF4E) is downstream in the mammalian target of rapamycin (mTOR) pathway. This study explored expression of eIF4E and its relationship with the PTEN/AKT and RAS/MEK/ERK pathways in non-small cell lung carcinoma (NSCLC).
  
  
  METHODS
  The status of phosphorylated eIF4E (p-eIF4E), phosphorylated AKT (p-AKT), PTEN, phosphorylated tuberin (p-TSC2), phosphorylated mTOR (p-mTOR), phosphorylated S6 (p-S6), and phosphorylated Erk1/2 (p-Erk1/2) was studied using immunohistochemical analysis applied to a tissue microarray containing 300 NSCLCs. Staining results for each antibody were compared with clinical and pathologic features, and the relationship between staining results was explored.
  
  
  RESULTS
  Overexpression of p-eIF4E, p-AKT, p-TSC2, p-mTOR, p-S6, and p-Erk1/2 in NSCLC was found in 39.9%, 78.8%, 5.1%, 46.7%, 27.1%, and 16.6% of tumors, respectively. The phenotype of p-eIF4E correlated positively with that of p-AKT, p-TSC2, and p-S6 (P < 0.001). Overall survival in NSCLC patients was significantly shorter in cases with overexpression of p-eIF4E and p-AKT alone and in combination (log-rank P < 0.001, each). Cases with underexpression of PTEN were limited (6.4%), and this phenotype did not correlate with any clinical variable. In cluster analysis, the p-AKT/p-mTOR/p-eIF4E/p-S6-positive group had significantly shorter survival compared with the survival of all cases (P < 0.001). Multivariate analysis showed that p-eIF4E overexpression is an independent prognostic factor for NSCLC (P = 0.004).
  
  
  CONCLUSIONS
  This study shows that p-eIF4E expression in addition to p-AKT predicts poor prognosis in NSCLC. Moreover, the correlation between expression of p-eIF4E with p-AKT, as well as p-TSC2 and p-S6, indicates that eIF4E activation through the AKT pathway plays an important role in the progression of NSCLC.
authors.affiliation: Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Yoshizawa
authors.forename: Junya
authors.initials: J
authors.lastname: Fukuoka
authors.forename: Shigeki
authors.initials: S
authors.lastname: Shimizu
authors.forename: Konstantin
authors.initials: K
authors.lastname: Shilo
authors.forename: Teri J
authors.initials: TJ
authors.lastname: Franks
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Hewitt
authors.forename: Takeshi
authors.initials: T
authors.lastname: Fujii
authors.forename: Carlos
authors.initials: C
authors.lastname: Cordon-Cardo
authors.forename: Jin
authors.initials: J
authors.lastname: Jen
authors.forename: William D
authors.initials: WD
authors.lastname: Travis
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000378:metabolism* / Q000401:mortality; D039561:Eukaryotic Initiation Factor-4E / Q000378:metabolism*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000378:metabolism* / Q000401:mortality; D008297:Male; D048052:Mitogen-Activated Protein Kinase 3 / Q000378:metabolism; D051059:PTEN Phosphohydrolase / Q000378:metabolism; D010766:Phosphorylation; D011379:Prognosis; D051057:Proto-Oncogene Proteins c-akt / Q000378:metabolism*; D015398:Signal Transduction; D046888:Tissue Array Analysis
chemical_list: D039561:Eukaryotic Initiation Factor-4E; D051057:Proto-Oncogene Proteins c-akt; D048052:Mitogen-Activated Protein Kinase 3; D051059:PTEN Phosphohydrolase; C494929:PTEN protein, human