Peroxiredoxin 4 as an independent prognostic marker for survival in patients with early-stage lung squamous cell carcinoma.
OBJECTIVE
Peroxiredoxin 4 (Prx 4) is a newly emerging antioxidant protein that has been studied in several human cancers. Recently, it was revealed that Prx 4 is highly expressed in human lung cancer and is needed for the promotion of lung cancer progression in vitro. However, there are no clinical data regarding the association of Prx 4 and prognosis in lung cancer.


METHODS
The Prx 4 expression state as a prognostic indicator was assessed by immunohistochemical staining in 142 patients with stage II non-small cell lung cancer (NSCLC) who had undergone curative surgery between 2006 and 2010. The association between the degree of Prx 4 expression and several clinicopathologic parameters was then evaluated by statistical analyses.


RESULTS
The degree of Prx 4 expression was associated with histology and recurrence in the overall NSCLC patient group, with the proportion of patients with positive Prx 4 expression significantly higher for the adenocarcinoma subtype (39/70, 56%) than the squamous cell carcinoma subtype (23/72, 32%) (P = 0.004). However, when subgroup analyses according to histopathology were performed in terms of recurrence, positive Prx 4 expression was significantly correlated with higher recurrence rates (P = 0.003) and shorter disease-free survival (DFS) (P = 0.003, hazard ratio = 3.910) in patients with squamous cell carcinoma. In contrast, no meaningful relationship was observed between the level of Prx 4 expression and DFS in the adenocarcinoma subgroup.


CONCLUSIONS
Positive Prx 4 expression is significantly correlated with recurrence and shorter DFS in patients with early-stage lung squamous cell carcinoma.
Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine Seoul, Korea.
Ji An
JA
Hwang
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine Seoul, Korea.
Joon Seon
JS
Song
Disease Model Research Laboratory, Aging Research Center, Korea Research Institute of Bioscience and Biotechnology Daejeon, Korea ; Department of Functional Genomics, University of Science and Technology Daejeon, Korea.
Dae Yeul
DY
Yu
Department of Thoracic Surgery, Asan Medical Center, University of Ulsan College of Medicine Seoul, Korea.
Hyeong Ryul
HR
Kim
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine Seoul, Korea.
Hye Jin
HJ
Park
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine Seoul, Korea.
Young Soo
YS
Park
Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine Seoul, Korea.
Woo Sung
WS
Kim
Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine Seoul, Korea.
Chang Min
CM
Choi
D000230:Adenocarcinoma / Q000737:chemistry* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000077192:Adenocarcinoma of Lung; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D002289:Carcinoma, Non-Small-Cell Lung / Q000737:chemistry* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000737:chemistry* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000737:chemistry* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D054464:Peroxiredoxins / Q000032:analysis*; D016016:Proportional Hazards Models; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; C515980:PRDX4 protein, human; D054464:Peroxiredoxins
Lung cancer; immunohistochemistry; peroxiredoxin