title: Prognostic significance of nestin expression in patients with resected non-small cell lung cancer treated with platinum-based adjuvant chemotherapy; relationship between nestin expression and epithelial to mesenchymal transition related markers.
abstract: BACKGROUND
  Although adjuvant platinum-based chemotherapy (AC) has been shown to improve survival of patients with completely resected stage II and stage IIIA non-small cell lung cancer (NSCLC), its effect is limited. Nestin is a class VI intermediate filament protein expressed in neural stem cells and several cancer cells including NSCLC. In the present study, we aimed to determine its prognostic significance concerning survival in NSCLC patients receiving AC.
  
  
  METHODS
  Nestin expression in cancer cells was immunohistochemically studied in 90 patients with completely resected stage II and stage IIIA NSCLC treated with AC and its association with clinicopathologic parameters, including ABCG2, E-cadherin, and vimentin expression, was evaluated. Kaplan-Meier survival analysis and Cox proportional hazards models were used to estimate the effect of nestin expression on survival.
  
  
  RESULTS
  Nestin expression was observed in 28 of the 90 (31.1%) NSCLCs. Clinicopathologically, nestin expression was associated with loss of E-cadherin expression (P = 0.006) and vimentin positive expression (P < 0.001). In survival analysis, nestin expression was significantly associated with a poorer prognosis (P = 0.028). Multivariable analysis confirmed that nestin expression is an independent prognostic indicator in NSCLC patients receiving AC (HR = 2.56; 95% CI, 1.23-5.30, P = 0.01).
  
  
  CONCLUSIONS
  The present study reveals that nestin expression is a prognostic indicator of a poorer survival probability in NSCLC patients receiving AC, although its prognostic significance still requires confirmation with larger patient populations.
authors.affiliation: Department of Respiratory Medicine, School of Medicine, Kitasato University, Kanagawa, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Ryuge
authors.affiliation: Department of Molecular Diagnostics, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Department of Molecular Diagnostics, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Nagashio
authors.affiliation: Department of Respiratory Medicine, School of Medicine, Kitasato University, Kanagawa, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Hiyoshi
authors.affiliation: Department of Respiratory Medicine, Sagamihara Kyodo Hospital, Kanagawa, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Katono
authors.affiliation: Department of Respiratory Medicine, School of Medicine, Kitasato University, Kanagawa, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Igawa
authors.affiliation: Department of Thoracic Surgery, School of Medicine, Kitasato University, Kanagawa, Japan.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Nakashima
authors.affiliation: Department of Thoracic Surgery, School of Medicine, Kitasato University, Kanagawa, Japan.
authors.forename: Kazu
authors.initials: K
authors.lastname: Shiomi
authors.affiliation: Department of Pathology, School of Medicine, Kitasato University, Kanagawa, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ichinoe
authors.affiliation: Department of Pathology, School of Medicine, Kitasato University, Kanagawa, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Murakumo
authors.affiliation: Department of Pathology, School of Medicine, Kitasato University, Kanagawa, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Saegusa
authors.affiliation: Department of Thoracic Surgery, School of Medicine, Kitasato University, Kanagawa, Japan.
authors.forename: Yukitoshi
authors.initials: Y
authors.lastname: Satoh
authors.affiliation: Department of Respiratory Medicine, School of Medicine, Kitasato University, Kanagawa, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Masuda
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000096:biosynthesis / Q000235:genetics*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D058750:Epithelial-Mesenchymal Transition / Q000187:drug effects; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009367:Neoplasm Staging; D064231:Nestin / Q000096:biosynthesis / Q000235:genetics*; D010984:Platinum / Q000008:administration & dosage; D011379:Prognosis
chemical_list: D014408:Biomarkers, Tumor; C577484:NES protein, human; D064231:Nestin; D010984:Platinum