title: Cytoplasmic and nuclear parathyroid hormone-related proteins are opposing prognostic factors in patients with non-small-cell lung cancer who have undergone curative resection.
abstract: OBJECTIVE
  Parathyroid hormone-like related protein was a prognostic factor for non-small-cell lung cancer, but the results were conflicting. The present study was to examine the role of cytoplasmic and nuclear parathyroid hormone-like related protein in patients with non-small-cell lung cancer who have undergone surgical therapy.
  
  
  METHODS
  The expression of parathyroid hormone-like related protein was examined by immunohistochemical staining in 56 patients with resectable non-small-cell lung cancer. The impact of parathyroid hormone-like related protein expression on cancer recurrence and survival was assessed in combination with clinicopathologic features.
  
  
  RESULTS
  Patients with a high expression of cytoplasmic parathyroid hormone-like related protein had a significantly unfavorable prognosis in both disease-free survival (median 16.7 vs. 58.0 months, P = 0.029) and overall survival (median 31.6 months vs. not reached, P = 0.046). In contrast, the patients with high expression of nuclear parathyroid hormone-like related protein had favorable disease-free survival (median 35.1 vs. 19.9 months, P = 0.069) and a significantly better overall survival (median not reached vs. 36.9 months, P = 0.033). There was no correlation between the expression of cytoplasmic and nuclear parathyroid hormone-like related protein (P = 1.00). Furthermore, multivariate analysis using a Cox regression model confirmed that high expression of cytoplasmic parathyroid hormone-like related protein (disease-free survival, hazard ratio: 1.973, P = 0.079; overall survival, hazard ratio: 2.461, P = 0.067) and nuclear parathyroid hormone-like related protein (disease-free survival, hazard ratio: 0.436, P = 0.029; overall survival, hazard ratio: 0.375, P = 0.018) were independently prognostic factors for disease-free survival and overall survival.
  
  
  CONCLUSIONS
  Cytoplasmic and nuclear parathyroid hormone-like related protein play opposing prognostic roles for the disease-free survival and overall survival of patients with early non-small-cell lung cancer who have undergone curative resection.
authors.affiliation: Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan Chang Gung University College of Medicine, Taoyuan.
authors.forename: Chiao-En
authors.initials: CE
authors.lastname: Wu
authors.affiliation: Chang Gung University College of Medicine, Taoyuan Department of Pathology, Chang Gung Memorial Hospital, Taoyuan.
authors.forename: Chi-Wei
authors.initials: CW
authors.lastname: Wang
authors.affiliation: Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan Chang Gung University College of Medicine, Taoyuan.
authors.forename: Wen-Kuan
authors.initials: WK
authors.lastname: Huang
authors.affiliation: Chang Gung University College of Medicine, Taoyuan Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan Department of Respiratory Care, Chang Gung University, Taoyuan.
authors.forename: Cheng-Ta
authors.initials: CT
authors.lastname: Yang
authors.affiliation: Chang Gung University College of Medicine, Taoyuan Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Taoyuan.
authors.forename: Yi-Cheng
authors.initials: YC
authors.lastname: Wu
authors.affiliation: Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan Chang Gung University College of Medicine, Taoyuan.
authors.forename: Ming-Mo
authors.initials: MM
authors.lastname: Hou
authors.affiliation: Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan Chang Gung University College of Medicine, Taoyuan.
authors.forename: Chia-Hsun
authors.initials: CH
authors.lastname: Hsieh
authors.affiliation: Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan Chang Gung University College of Medicine, Taoyuan Institute of Bioscience and Biotechnology and Center of Excellence for Marine Bioenvironment and Biotechnology, National Taiwan Ocean University, Keelung, Taiwan.
authors.forename: Jia-Juan
authors.initials: JJ
authors.lastname: Hsieh
authors.affiliation: Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan Chang Gung University College of Medicine, Taoyuan.
authors.forename: Hsin-Yi
authors.initials: HY
authors.lastname: Cheng
authors.affiliation: Institute of Bioscience and Biotechnology and Center of Excellence for Marine Bioenvironment and Biotechnology, National Taiwan Ocean University, Keelung, Taiwan.
authors.forename: Todd
authors.initials: T
authors.lastname: Hsu
authors.affiliation: Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan Chang Gung University College of Medicine, Taoyuan wen1902@hotmail.com.
authors.forename: John Wen-Cheng
authors.initials: JW
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000378:metabolism / Q000401:mortality / Q000601:surgery*; D002467:Cell Nucleus / Q000378:metabolism*; D003593:Cytoplasm / Q000378:metabolism*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000378:metabolism / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology / Q000378:metabolism / Q000401:mortality; D044162:Parathyroid Hormone-Related Protein / Q000378:metabolism*; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D044162:Parathyroid Hormone-Related Protein
keywords: PTHrP; non-small-cell lung cancer; prognostic factor