title: Periostin and tumor-stroma interactions in non-small cell lung cancer.
abstract: Non-small cell lung cancer (NSCLC) is one of the leading causes of cancer-associated mortality globally. Interactions of the cancer cells with the tumor microenvironment are essential carcinogenic features for the majority of solid tumors, such as pancreatic cancer. The present study investigated the role of stromal activation in NSCLC and analyzed the surgical specimens of 93 patients by immunohistochemistry with regard to periostin (an extracellular matrix protein), α-smooth muscle actin (α-SMA; a marker of myofibroblasts) and cluster of differentiation 31 (CD31; a marker of endothelial cells), and the activated stroma index. There was a trend towards reduced overall survival for patients with high periostin expression (hazard ratio, 1.80; 95% confidence interval, 0.99-3.27; P=0.050). No significant correlations with overall survival were identified for α-SMA (P=0.930), CD31 (P=0.923), collagen (P=0.441) or the activated stroma index (P=0.706). In a multivariable analysis, the histological tumor subtype, tumor stage, lymph node involvement and resection status were independent prognostic factors in NSCLC, but none of the investigated immunohistochemical markers were prognostic factors. Thus, the tumor microenvironment and stroma activation did not prove to be of prognostic relevance for lung cancer, as it has been previously described for pancreatic cancer. Other markers of the microenvironment of NSCLC may be of higher prognostic value, pointing towards tumor-type specific effects.
authors.affiliation: Department of Surgery, Klinikum Rechts Der Isar, Technical University of Munich, D-81675 Munich, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Nitsche
authors.affiliation: Department of Surgery, Klinikum Rechts Der Isar, Technical University of Munich, D-81675 Munich, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Stangel
authors.affiliation: Department of Surgery, Klinikum Rechts Der Isar, Technical University of Munich, D-81675 Munich, Germany.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Pan
authors.affiliation: Institute of Pathology, Technical University of Munich, D-81675 Munich, Germany.
authors.forename: Anna Melissa
authors.initials: AM
authors.lastname: Schlitter
authors.affiliation: Institute of Pathology, Medical University of Innsbruck, A-6020 Innsbruck, Austria.
authors.forename: Irene
authors.initials: I
authors.lastname: Esposito
authors.affiliation: Department of Surgery, Klinikum Rechts Der Isar, Technical University of Munich, D-81675 Munich, Germany.
authors.forename: Ivonne
authors.initials: I
authors.lastname: Regel
authors.affiliation: Department of Surgery, Klinikum Rechts Der Isar, Technical University of Munich, D-81675 Munich, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Raulefs
authors.affiliation: Department of Surgery, Klinikum Rechts Der Isar, Technical University of Munich, D-81675 Munich, Germany.
authors.forename: Helmut
authors.initials: H
authors.lastname: Friess
authors.affiliation: Department of Surgery, Klinikum Rechts Der Isar, Technical University of Munich, D-81675 Munich, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Kleeff
authors.affiliation: Department of Surgery, Koc University School of Medicine, Koc University Hospital, 34010 Istanbul, Turkey.
authors.forename: Mert
authors.initials: M
authors.lastname: Erkan
keywords: lung cancer; microenvironment; non-small cell lung cancer; periostin; stroma