title: Peripheral immune cell gene expression changes in advanced non-small cell lung cancer patients treated with first line combination chemotherapy.
abstract: BACKGROUND
  Increasing evidence has shown that immune surveillance is compromised in a tumor-promoting microenvironment for patients with non-small cell lung cancer (NSCLC), and can be restored by appropriate chemotherapy.
  
  
  METHODS
  To test this hypothesis, we analyzed microarray gene expression profiles of peripheral blood mononuclear cells from 30 patients with newly-diagnosed advanced stage NSCLC, and 20 age-, sex-, and co-morbidity-matched healthy controls. All the patients received a median of four courses of chemotherapy with cisplatin and gemcitabine for a 28-day cycle as first line treatment.
  
  
  RESULTS
  Sixty-nine differentially expressed genes between the patients and controls, and 59 differentially expressed genes before and after chemotherapy were identified. The IL4 pathway was significantly enriched in both tumor progression and chemotherapy signatures. CXCR4 and IL2RG were down-regulated, while DOK2 and S100A15 were up-regulated in the patients, and expressions of all four genes were partially or totally reversed after chemotherapy. Real-time quantitative RT-PCR for the four up-regulated (S100A15, DOK2) and down-regulated (TLR7, TOP1MT) genes in the patients, and the six up-regulated (TLR7, CRISP3, TOP1MT) and down-regulated (S100A15, DOK2, IL2RG) genes after chemotherapy confirmed the validity of the microarray results. Further immunohistochemical analysis of the paraffin-embedded lung cancer tissues identified strong S100A15 nuclear staining not only in stage IV NSCLC as compared to stage IIIB NSCLC (p = 0.005), but also in patients with stable or progressive disease as compared to those with a partial response (p = 0.032). A high percentage of S100A15 nuclear stained cells (HR 1.028, p = 0.01) was the only independent factor associated with three-year overall mortality.
  
  
  CONCLUSIONS
  Our results suggest a potential role of the IL4 pathway in immune surveillance of advanced stage NSCLC, and immune potentiation of combination chemotherapy. S100A15 may serve as a potential biomarker for tumor staging, and a predictor of poor prognosis in NSCLC.
authors: Division of Pulmonary and Critical Care Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors: Yung-Che
authors: YC
authors: Chen
authors: Chang-Chun
authors: CC
authors: Hsiao
authors: Kuang-Den
authors: KD
authors: Chen
authors: Yu-Chiang
authors: YC
authors: Hung
authors: Ching-Yuan
authors: CY
authors: Wu
authors: Chien-Hao
authors: CH
authors: Lie
authors: Shih-Feng
authors: SF
authors: Liu
authors: Ming-Tse
authors: MT
authors: Sung
authors: Chung-Jen
authors: CJ
authors: Chen
authors: Ting-Ya
authors: TY
authors: Wang
authors: Jen-Chieh
authors: JC
authors: Chang
authors: Petrus
authors: P
authors: Tang
authors: Wen-Feng
authors: WF
authors: Fang
authors: Yi-Hsi
authors: YH
authors: Wang
authors: Yu-Hsiu
authors: YH
authors: Chung
authors: Tung-Ying
authors: TY
authors: Chao
authors: Sum-Yee
authors: SY
authors: Leung
authors: Mao-Chang
authors: MC
authors: Su
authors: Chin-Chou
authors: CC
authors: Wang
authors: Meng-Chih
authors: MC
authors: Lin
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology; D016022:Case-Control Studies; D005260:Female; D020869:Gene Expression Profiling; D006801:Humans; D007962:Leukocytes / Q000378:metabolism*; D008175:Lung Neoplasms / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology; D008297:Male; D008875:Middle Aged
chemical_list: D000970:Antineoplastic Agents