title: The impact of phosphorylated AMP-activated protein kinase expression on lung cancer survival.
abstract: BACKGROUND
  The aim of this study is to investigate the prognostic role of phosphorylated AMP-activated protein kinase (pAMPK) in surgically resected non-small-cell lung cancer (NSCLC).
  
  
  METHODS
  Immunohistochemical staining of pAMPK was carried out on tissue microarrays containing 463 samples obtained from patients with NSCLC and correlated with clinicopathological characteristics and survival.
  
  
  RESULTS
  pAMPK expression levels were significantly higher in never smokers versus former smokers versus current smokers (P=0.045). A positive pAMPK expression was associated with increased overall survival (OS) and recurrence-free survival (RFS) (P=0.0009 and P=0.0007, respectively). OS and RFS were statistically superior in pAMPK-positive than in pAMPK-negative patients with adenocarcinoma (ADC; median OS: 5.6 and 4.2 years, respectively, P=0.0001; median RFS: 5.0 and 2.4 years, respectively, P=0.001), whereas they were similar in those patients with squamous cell carcinoma. Multivariate analysis confirmed that pAMPK positivity was associated with OS [hazard ratio (HR)=0.574, 95% confidence interval (CI) 0.418-0.789, P=0.0006) and RFS (HR=0.608, 95% CI 0.459-0.807, and P=0.0006), independent of clinical covariates.
  
  
  CONCLUSIONS
  High pAMPK expression levels are associated with increased survival in patients with NSCLC, especially those with ADC. Our results support further evaluation of AMP-activated protein kinase as a potential prognostic and therapeutic target for lung cancer.
authors: Departments of Thoracic/Head & Neck Medical Oncology.
authors: W N
authors: WN
authors: William
authors: Departments of Thoracic/Head & Neck Medical Oncology.
authors: J-S
authors: JS
authors: Kim
authors: Departments of Biostatistics.
authors: D D
authors: DD
authors: Liu
authors: Departments of Biostatistics Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA.
authors: L
authors: L
authors: Solis
authors: Departments of Thoracic/Head & Neck Medical Oncology.
authors: C
authors: C
authors: Behrens
authors: Departments of Biostatistics.
authors: J J
authors: JJ
authors: Lee
authors: Departments of Thoracic/Head & Neck Medical Oncology.
authors: S M
authors: SM
authors: Lippman
authors: Departments of Thoracic/Head & Neck Medical Oncology.
authors: E S
authors: ES
authors: Kim
authors: Departments of Thoracic/Head & Neck Medical Oncology.
authors: W K
authors: WK
authors: Hong
authors: Departments of Thoracic/Head & Neck Medical Oncology; Departments of Biostatistics Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA.
authors: I I
authors: II
authors: Wistuba
authors: Departments of Thoracic/Head & Neck Medical Oncology; Departments of College of Pharmacy, Seoul National University, Seoul, Republic of Korea. Electronic address: hylee135@snu.ac.kr.
authors: H-Y
authors: HY
authors: Lee
mesh_terms: D055372:AMP-Activated Protein Kinases / Q000096:biosynthesis*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D002289:Carcinoma, Non-Small-Cell Lung / Q000378:metabolism* / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000378:metabolism* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010766:Phosphorylation; D011379:Prognosis; D016016:Proportional Hazards Models; D046888:Tissue Array Analysis
chemical_list: D014408:Biomarkers, Tumor; D055372:AMP-Activated Protein Kinases