title: Blood group antigen A type 3 expression is a favorable prognostic factor in advanced NSCLC.
abstract: OBJECTIVE
  Several blood group-related carbohydrate antigens are prognosis-relevant markers of tumor tissues. A type 3 (repetitive A) is a blood group antigen specific for A1 erythrocytes. Its potential expression in tumor tissues has so far not been examined.
  
  
  METHODS
  We have evaluated its expression in normal lung and in lung cancer using a novel antibody (A69-A/E8). For comparison an anti-A antibody specific to A types 1 and 2 was used, because its expression on lung cancer tissue has been previously reported to be of prognostic relevance. Resected tissue samples of 398 NSCLC patients were analyzed in immunohistochemistry using tissue microarrays.
  
  
  CONCLUSIONS
  Expression of A type 3 was not observed in non-malignant lung tissues. A type 3 was expressed on tumor cells of around half of NSCLC patients of blood group A1 (p<0.001). Whereas no prognostic effect for A type 1/2 antigen was observed (p=0.562), the expression of A type 3 by tumor cells indicated a highly significant favorable prognosis among advanced NSCLC patients (p=0.011) and in NSCLC patients with lymphatic spread (p=0.014). Univariate prognostic results were confirmed in a Cox proportional hazards model. In this study we present for the first time prognostic data for A type 3 antigen expression in lung cancer patients. Prospective studies should be performed to confirm the prognostic value of A type 3 expression for an improved risk stratification in NSCLC patients.
authors.affiliation: Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Münster, Germany. Electronic address: larshenning.schmidt@ukmuenster.de.
authors.forename: L H
authors.initials: LH
authors.lastname: Schmidt
authors.affiliation: Pulmonary Division, Department of Medicine III, Johannes Gutenberg University Medical Center, 55101 Mainz, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Kuemmel
authors.affiliation: Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Münster, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Schliemann
authors.affiliation: Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Münster, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Schulze
authors.affiliation: Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Münster, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Humberg
authors.affiliation: Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Münster, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Mohr
authors.affiliation: Institute of Biostatistics and Clinical Research, Westfälische Wilhelms-Universität Münster, 48149 Münster, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Görlich
authors.affiliation: Gerhard-Domagk-Institute of Pathology, University of Münster, Münster, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Hartmann
authors.affiliation: Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Münster, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Bröckling
authors.affiliation: Chest Surgery, Klinikum St. Georg, Ostercappeln, 48179 Ostercappeln, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Marra
authors.affiliation: Chest Surgery, Klinikum St. Georg, Ostercappeln, 48179 Ostercappeln, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Hillejan
authors.affiliation: Glycotope GmbH, 13125 Berlin, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Goletz
authors.affiliation: Glycotope GmbH, 13125 Berlin, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Karsten
authors.affiliation: Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Münster, Germany.
authors.forename: W E
authors.initials: WE
authors.lastname: Berdel
authors.affiliation: Institute of Pathology at the St. Franziskus Hospital Münster, 48145 Münster, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Spieker
authors.affiliation: Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Münster, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Wiewrodt
mesh_terms: D000368:Aged; D000951:Antigens, Neoplasm / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D001789:Blood Group Antigens / Q000096:biosynthesis / Q000097:blood*; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood* / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000097:blood* / Q000378:metabolism / Q000473:pathology; D008297:Male; D011379:Prognosis; D016019:Survival Analysis; D046888:Tissue Array Analysis
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D001789:Blood Group Antigens
keywords: Biomarkers; Blood group-related antigens; Immunohistochemistry; NSCLC; Prognosis; Repetitive A antigen