Graziano S L, Tatum A H, Gonchoroff N J, Newman N B, Kohman L J
Department of Medicine, Veterans Affairs Medical Center and State University of New York Health Science Center, Syracuse, New York 13210, USA.
Clin Cancer Res. 1997 Jan;3(1):87-93.
The loss of blood group antigen A on tumor tissue has been reported to be a strong adverse prognostic marker for patients with resected non-small cell lung cancer (NSCLC). Results have varied with respect to the prognostic significance of flow cytometric data. We sought to confirm the prognostic significance of blood group antigen A loss and flow cytometry in a large cohort of patients with early-stage NSCLC. Two hundred and sixty patients with surgically resected stage I (n = 193) and II (n = 67) NSCLC with at least a 5-year follow-up were identified. Using paraffin-embedded primary tumor, immunohistochemical stains for blood group antigen A were performed on 90 patients with blood type A or AB. The DNA index and percentage of cells in S phase were successfully obtained on 188 and 152 patients, respectively. The median survival time of the patients with primary tumors negative for blood group antigen A was 38 months (n = 36), compared with 98 months (n = 54) for those with antigen A-positive tumors (P < 0.01). The median disease-free survival times for antigen A-negative and -positive tumors were 26 months and 98 months, respectively (P < h 0.01). The median survival time of the patients with aneuploid tumors was 51 months (n = 131), compared with 50 months (n = 57) for those with diploid tumors (P = 0.42). The median survival time of the patients with S phase >8% was 44 months (n = 105), compared with 60 months (n = 47) for those with S phase </=8% (P = 0.18). Multivariate analysis showed that the loss of antigen A, higher N and T stages, and the presence of mucin predicted for poorer disease-free and overall survival. In the subgroup of patients with blood group A or AB, the loss of A antigen was the most powerful negative predictor of survival. Aneuploidy and percentage of cells in S phase were not of prognostic significance in this group of patients with resected stage I and II NSCLC. The value of blood group antigen A analysis needs to be evaluated in larger and prospective studies of early-stage NSCLC. Alteration of blood group antigen cell surface expression may represent an important marker for more aggressive biological and metastatic behavior in NSCLC.
据报道，肿瘤组织上血型抗原A的缺失是接受手术切除的非小细胞肺癌（NSCLC）患者的一个强烈不良预后标志物。流式细胞术数据的预后意义结果各异。我们试图在一大群早期NSCLC患者中证实血型抗原A缺失和流式细胞术的预后意义。确定了260例接受手术切除的I期（n = 193）和II期（n = 67）NSCLC患者，且至少有5年的随访。使用石蜡包埋的原发性肿瘤，对90例A型或AB型血患者进行血型抗原A的免疫组织化学染色。分别成功获得了188例和152例患者的DNA指数和S期细胞百分比。血型抗原A阴性原发性肿瘤患者的中位生存时间为38个月（n = 36），而抗原A阳性肿瘤患者为98个月（n = 54）（P < 0.01）。抗原A阴性和阳性肿瘤的无病生存时间中位数分别为26个月和98个月（P < 0.01）。非整倍体肿瘤患者的中位生存时间为51个月（n = 131），而二倍体肿瘤患者为50个月（n = 57）（P = 0.42）。S期>8%的患者中位生存时间为44个月（n = 105），而S期≤8%的患者为60个月（n = 47）（P = 0.18）。多因素分析显示，抗原A缺失、更高的N和T分期以及黏液的存在预示着无病生存和总生存较差。在A型或AB型血患者亚组中，A抗原缺失是生存的最有力负性预测因素。在这组接受手术切除的I期和II期NSCLC患者中，非整倍体和S期细胞百分比无预后意义。血型抗原A分析的价值需要在更大规模的早期NSCLC前瞻性研究中进行评估。血型抗原细胞表面表达的改变可能代表NSCLC中更具侵袭性的生物学和转移行为的一个重要标志物。
