title: High circulating activin A level is associated with tumor progression and predicts poor prognosis in lung adenocarcinoma.
abstract: Activin A (ActA)/follistatin (FST) signaling has been shown to be deregulated in different tumor types including lung adenocarcinoma (LADC). Here, we report that serum ActA protein levels are significantly elevated in LADC patients (n=64) as compared to controls (n=46, p=0.015). ActA levels also correlated with more advanced disease stage (p<0.0001) and T (p=0.0035) and N (p=0.0002) factors. M1 patients had significantly higher ActA levels than M0 patients (p<0.001). High serum ActA level was associated with poor overall survival (p<0.0001) and was confirmed as an independent prognostic factor (p=0.004). Serum FST levels were increased only in female LADC patients (vs. female controls, p=0.031). Two out of five LADC cell lines secreted biologically active ActA, while FST was produced in all of them. Transcripts of both type I and II ActA receptors were detected in all five LADC cell lines. In conclusion, our study does not only suggest that measuring blood ActA levels in LADC patients might improve the prediction of prognosis, but also indicates that this parameter might be a novel non-invasive biomarker for identifying LADC patients with organ metastases.
authors.affiliation: Translational Thoracic Oncology Laboratory, Division of Thoracic Surgery, Department of Surgery, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria.|Institute of Cancer Research, Department of Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria.
authors.forename: Mir Alireza
authors.initials: MA
authors.lastname: Hoda
authors.affiliation: Translational Thoracic Oncology Laboratory, Division of Thoracic Surgery, Department of Surgery, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria.|National Koranyi Institute of Pulmonology, Budapest, Hungary.
authors.forename: Anita
authors.initials: A
authors.lastname: Rozsas
authors.affiliation: Institute of Cancer Research, Department of Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Lang
authors.affiliation: Translational Thoracic Oncology Laboratory, Division of Thoracic Surgery, Department of Surgery, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Klikovits
authors.affiliation: National Koranyi Institute of Pulmonology, Budapest, Hungary.
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Lohinai
authors.affiliation: National Koranyi Institute of Pulmonology, Budapest, Hungary.
authors.forename: Szilvia
authors.initials: S
authors.lastname: Torok
authors.affiliation: National Koranyi Institute of Pulmonology, Budapest, Hungary.
authors.forename: Judit
authors.initials: J
authors.lastname: Berta
authors.affiliation: National Koranyi Institute of Pulmonology, Budapest, Hungary.
authors.forename: Matyas
authors.initials: M
authors.lastname: Bendek
authors.affiliation: Institute of Cancer Research, Department of Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria.
authors.forename: Walter
authors.initials: W
authors.lastname: Berger
authors.affiliation: Translational Thoracic Oncology Laboratory, Division of Thoracic Surgery, Department of Surgery, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria.|MTA-SE Molecular Oncology Research Group, Hungarian Academy of Sciences, Budapest, Hungary.
authors.forename: Balazs
authors.initials: B
authors.lastname: Hegedus
authors.affiliation: Translational Thoracic Oncology Laboratory, Division of Thoracic Surgery, Department of Surgery, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria.
authors.forename: Walter
authors.initials: W
authors.lastname: Klepetko
authors.affiliation: Department of Thoracic Surgery, National Institute of Oncology and Semmelweis University, Budapest, Hungary.
authors.forename: Ferenc
authors.initials: F
authors.lastname: Renyi-Vamos
authors.affiliation: Institute of Cancer Research, Department of Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Grusch
authors.affiliation: Translational Thoracic Oncology Laboratory, Division of Thoracic Surgery, Department of Surgery, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria.|National Koranyi Institute of Pulmonology, Budapest, Hungary.|Department of Thoracic Surgery, National Institute of Oncology and Semmelweis University, Budapest, Hungary.|Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.
authors.forename: Balazs
authors.initials: B
authors.lastname: Dome
authors.affiliation: Translational Thoracic Oncology Laboratory, Division of Thoracic Surgery, Department of Surgery, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria.
authors.forename: Viktoria
authors.initials: V
authors.lastname: Laszlo
mesh_terms: D028341:Activins / Q000378:metabolism*; D000230:Adenocarcinoma / Q000175:diagnosis / Q000378:metabolism*; D000077192:Adenocarcinoma of Lung; D014408:Biomarkers, Tumor / Q000378:metabolism*; D016022:Case-Control Studies; D049109:Cell Proliferation; D005260:Female; D038681:Follistatin / Q000378:metabolism*; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000378:metabolism*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D015996:Survival Rate; D014407:Tumor Cells, Cultured
chemical_list: D014408:Biomarkers, Tumor; D038681:Follistatin; C422405:activin A; D028341:Activins
keywords: Pathology Section; activin A; biomarker; follistatin; lung adenocarcinoma; metastasis