title: Prognostic implications of parathyroid hormone-related protein in males and females with non--small-cell lung cancer.
abstract: BACKGROUND
  Non-small-cell lung carcinoma immunoreactivity for parathyroid hormone-related protein has been associated with increased survival in female patients but not in male patients. The current investigation attempted to substantiate this finding in 2 new patient groups.
  
  
  METHODS
  Patients were divided into groups with and without immunoreactivity for a carboxyl-terminal parathyroid hormone-related protein epitope assessed in deparaffinized sections by a blinded observer. One group included 85 female patients with stage I lung cancer, and the second group had 48 female and 66 male patients with stage I-IV lung cancer. Survival times were compared by the log-rank test between groups separated by tumor parathyroid hormone-related protein status.
  
  
  RESULTS
  Parathyroid hormone-related protein was present in 70%-80% of the patients, independent of sex, stage, and smoking history. In the females with stage I lung cancer, parathyroid hormone-related protein increased median survival from 25 to 60 months (P < .05). In the second group, parathyroid hormone-related protein expression increased 48-month disease-free survival of female lung cancer patients from 44% to 63% (P < .05), but had no effect in male patients. Parathyroid hormone-related protein remained a significant, independent predictor when evaluated together with other covariates by Cox multivariate regression.
  
  
  CONCLUSIONS
  This study verifies that parathyroid hormone-related protein is a sex-dependent survival factor for non-small-cell lung carcinoma, that it correlates with disease-free survival, and that the association with survival holds for women with early-stage disease as well as more advanced cancer. Thus, the protein could find use as a prognostic indicator and could be a target for therapy.
authors.affiliation: Research, Anesthesiology and Medicine Services, VA San Diego Healthcare System, San Diego, CA 92161, USA.
authors.forename: Philippe R
authors.initials: PR
authors.lastname: Montgrain
authors.forename: Leonard J
authors.initials: LJ
authors.lastname: Deftos
authors.forename: Douglas
authors.initials: D
authors.lastname: Arenberg
authors.forename: Ann
authors.initials: A
authors.lastname: Tipps
authors.forename: Rick
authors.initials: R
authors.lastname: Quintana
authors.forename: Shannon
authors.initials: S
authors.lastname: Carskadon
authors.forename: Randolph H
authors.initials: RH
authors.lastname: Hastings
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000737:chemistry / Q000401:mortality* / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000737:chemistry / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D044162:Parathyroid Hormone-Related Protein / Q000032:analysis*; D011379:Prognosis; D012727:Sex Characteristics
chemical_list: D044162:Parathyroid Hormone-Related Protein