Bepler Gerold, Gautam Ashish, McIntyre Lauren M, Beck Amy F, Chervinsky David S, Kim Young-Chul, Pitterle Diana M, Hyland Andrew
Lung Cancer Program, Roswell Park Cancer Institute, Buffalo, NY, USA.
J Clin Oncol. 2002 Mar 1;20(5):1353-60. doi: 10.1200/JCO.2002.20.5.1353.
The assessment of prognosis and decisions on treatment for patients with non-small-cell lung cancer (NSCLC) are determined on the basis of disease stage and performance status. NSCLC frequently manifests loss of heterozygosity (LOH) at chromosome segment 11p15.5. Whether LOH at 11p15.5 is an independent prognostic variable has yet to be determined.
We developed five novel markers, which can be assessed by polymerase chain reaction and restriction enzyme digestion. LOH at 11p15.5 was assessed in 193 patients who underwent surgical resection for pathologic stage I and II of the disease.
LOH at 11p15.5 was associated with poor survival (P =.021). Multivariate logistic regression analysis showed that after disease stage, performance status, weight loss, sex, age at diagnosis, and smoking history were controlled for, patients with LOH were two times more likely to die than those without LOH (relative risk [RR] = 2.01, P =.021). Cox regression analysis with disease stage and LOH revealed that the survival of patients with stage I disease and LOH was similar to the survival of patients with stage II disease, and it was significantly worse than the survival of stage I patients without LOH (RR = 2.38, P =.038).
LOH in a 310-kb region on chromosome segment 11p15.5 that includes the gene for the regulatory subunit of the enzyme ribonucleotide reductase is highly predictive of poor survival from NSCLC. The future utility of analysis of the allelic status of this region may involve treatment decisions, such as the use of neoadjuvant and adjuvant chemotherapy for patients with stage I disease.
非小细胞肺癌(NSCLC)患者的预后评估和治疗决策是基于疾病分期和体能状态来确定的。NSCLC常表现出11p15.5染色体区段杂合性缺失(LOH)。11p15.5处的LOH是否为独立的预后变量尚未确定。
我们开发了五个新型标志物,可通过聚合酶链反应和限制性酶切来评估。对193例接受了该疾病病理I期和II期手术切除的患者评估了11p15.5处的LOH。
11p15.5处的LOH与较差的生存率相关(P = 0.021)。多因素逻辑回归分析显示,在控制了疾病分期、体能状态、体重减轻、性别、诊断时年龄和吸烟史后,有LOH的患者死亡可能性是无LOH患者的两倍(相对风险[RR]=2.01,P = 0.021)。对疾病分期和LOH进行的Cox回归分析显示,I期疾病且有LOH的患者生存率与II期疾病患者相似,且显著差于无LOH的I期患者(RR = 2.38,P = 0.038)。
11p15.5染色体区段一个310 kb区域内的LOH,该区域包含核糖核苷酸还原酶调节亚基的基因,高度预示NSCLC患者的不良生存。该区域等位基因状态分析的未来应用可能涉及治疗决策,如对I期疾病患者使用新辅助和辅助化疗。