title: Clinical implications of fibroblast activation protein-α in non-small cell lung cancer after curative resection: a new predictor for prognosis.
abstract: BACKGROUND
  Fibroblast activation protein-α (FAP-α), which is a serine protease specially expressed on the surface of the cancer stromal cells, plays an important role in the progression and prognosis in diverse malignancies. However, the role of FAP-α in non-small cell lung cancer (NSCLC) is still unknown.
  
  
  METHODS
  We enrolled 59 NSCLC patients who received complete resection. Sections of paraffin-embedded primary NSCLC specimens of all the patients were stained with antibody directed against FAP-α. Overall, percentage (Grade 0-3) and intensity (0-3+) of stromal FAP-α staining of the tumor were assessed.
  
  
  RESULTS
  FAP-α was detected in >76 % of the specimens examined, and its high expression seemed to be correlated with poor tumor differentiation (P = 0.06). Furthermore, both increased FAP-α staining percentage and intensity were associated with worse overall survival of the patients (percentage, P = 0.0087; intensity, P = 0.05). Higher FAP-α staining percentage was observed in those patients with increased peripheral neutrophil and lymphocyte count ratio (P = 0.034).
  
  
  CONCLUSIONS
  FAP-α is highly expressed in cancer stroma and also a predictor of poor survival of NSCLC patients. Elevated FAP-α expression may be associated with inflammation and suppressed lymphocyte-dependent immune response, which then result in the tumor progression. Therefore, FAP-α plays an important role in the progression of NSCLC, and its high expression is a predictor of poor survival. Targeting FAP-α may be a novel strategy for NSCLC therapy.
authors.affiliation: Department of Thoracic Surgery, Provincial Hospital Affiliated to Shandong University, Shandong University, 324 Jingwu Road, Jinan, 250021, People's Republic of China.
authors.forename: Yida
authors.initials: Y
authors.lastname: Liao
authors.forename: Yang
authors.initials: Y
authors.lastname: Ni
authors.forename: Ren
authors.initials: R
authors.lastname: He
authors.forename: Weidong
authors.initials: W
authors.lastname: Liu
authors.forename: Jiajun
authors.initials: J
authors.lastname: Du
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism* / Q000401:mortality / Q000601:surgery; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002289:Carcinoma, Non-Small-Cell Lung / Q000378:metabolism* / Q000401:mortality / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000401:mortality / Q000601:surgery; D018450:Disease Progression; D010450:Endopeptidases; D005260:Female; D005500:Follow-Up Studies; D018093:Gelatinases / Q000378:metabolism*; D006801:Humans; D007124:Immunoenzyme Techniques; D008175:Lung Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000601:surgery; D008207:Lymphatic Metastasis; D008214:Lymphocytes / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D008297:Male; D008565:Membrane Proteins / Q000378:metabolism*; D008875:Middle Aged; D009367:Neoplasm Staging; D009504:Neutrophils / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D011379:Prognosis; D012697:Serine Endopeptidases / Q000378:metabolism*; D015996:Survival Rate; D000099167:Fibroblast Activation Protein Alpha
chemical_list: D014408:Biomarkers, Tumor; D010450:Endopeptidases; D018093:Gelatinases; D008565:Membrane Proteins; D012697:Serine Endopeptidases; D000099167:Fibroblast Activation Protein Alpha