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Expression of Cystatin SN significantly correlates with recurrence, metastasis, and survival duration in surgically resected non-small cell lung cancer patients.

Cao X, Li Y, Luo RZ, Zhang L, Zhang SL, Zeng J, Han YJ, Wen ZS - Sci Rep (2015)

Bottom Line: Disease-free survival (DFS) and overall survival (OS) were significantly prolonged in the low-Cystatin SN expression subgroup compared with the high-Cystatin SN expression subgroup (DFS, P < 0.001; OS, P = 0.001).A multivariate analysis confirmed that high expression of Cystatin SN was associated with poor survival (DFS, P = 0.001; OS, P = 0.006) and was an independent prognostic indicator.The present study indicates that high expression of Cystatin SN is a significant prognostic indicator of a higher rate of recurrence, metastatic risk, and poor survival in patients with surgically resected NSCLCs.

View Article: PubMed Central - PubMed

Affiliation: Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China.

ABSTRACT
Cystatin SN has been considered to be involved in human cancer, but its clinical significance in non-small cell lung cancer (NSCLC) has not been elucidated. The aim of this study was to evaluate the clinical value of Cystatin SN expression in patients with surgically resected NSCLCs. A retrospective analysis of 174 patients with surgically resected NSCLCs from April 2002 to March 2005 was performed with immunohistochemistry and fluorescence in situ hybridization to analyze the protein expression and amplification of Cystatin SN. The associations between Cystatin SN expression and recurrence, metastasis, and survival were investigated. In recurrence and metastasis analysis, compared with low-Cystatin SN expression NSCLCs, high expression tumors were more likely to recur and metastasize (P < 0.001). Disease-free survival (DFS) and overall survival (OS) were significantly prolonged in the low-Cystatin SN expression subgroup compared with the high-Cystatin SN expression subgroup (DFS, P < 0.001; OS, P = 0.001). A multivariate analysis confirmed that high expression of Cystatin SN was associated with poor survival (DFS, P = 0.001; OS, P = 0.006) and was an independent prognostic indicator. The present study indicates that high expression of Cystatin SN is a significant prognostic indicator of a higher rate of recurrence, metastatic risk, and poor survival in patients with surgically resected NSCLCs.

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Kaplan-Meier estimates of the probability of survival in patients with non-small cell lung cancer.(A) Disease-free survival (DFS) and (B) Overall survival (OS) curves for the whole cohort of patients with NSCLC; (C) DFS and (D) OS curves for the adenocarcinoma patients; (E) DFS and (F) OS curves for the SCC patients according the Cystatin SN protein expression level.
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f3: Kaplan-Meier estimates of the probability of survival in patients with non-small cell lung cancer.(A) Disease-free survival (DFS) and (B) Overall survival (OS) curves for the whole cohort of patients with NSCLC; (C) DFS and (D) OS curves for the adenocarcinoma patients; (E) DFS and (F) OS curves for the SCC patients according the Cystatin SN protein expression level.

Mentions: All patients were included in the survival analysis. The median follow-up period was 41.5 months. A total of 67 patients were alive and 107 cancer-related deaths had occurred at the time of the last clinical follow-up. The five-year survival probability was 22% for the high Cystatin SN expression subgroup and 48% for the low Cystatin SN expression subgroup. According to the Kaplan-Meier analysis, the expression level of Cystatin SN was significantly associated with DFS and OS. For the full cohort, the median DFS was longer in patients with low Cystatin SN expression compared with those with high Cystatin SN expression (36 months vs. 15 months, P < 0.001) [Fig. 3(A)]. The median OS was 63 months for patients with low Cystatin SN expression and 36 months for patients with high Cystatin SN expression (P = 0.001) [Fig. 3(B)]. Furthermore, when we carried out the survival analyses in each histology subgroup, the benefit of low Cystatin SN expression was significant in patients with adenocarcinoma (DFS, 32 vs. 13 months, P = 0.004; OS, 63 vs. 24 months, P = 0.005) [Fig. 3(C–D)], whereas OS duration was similar between high and low-Cystatin SN expression subsets in SCC patients (57 vs. 46 months, P = 0.094) [Fig. 3(E–F)]. To determine whether Cystatin SN protein expression could serve as an independent prognostic parameter, we examined DFS and OS using univariate and multivariate Cox proportional hazards models. The results revealed that Cystatin SN expression (DFS, P = 0.001; OS, P = 0.006), pTNM stage (DFS, P < 0.001; OS, P < 0.001) and adjuvant chemotherapy (DFS, P < 0.001; OS, P < 0.001) were independent, significant predictors of DFS and OS. The details of these results are presented in Table 3 and Table 4.


Expression of Cystatin SN significantly correlates with recurrence, metastasis, and survival duration in surgically resected non-small cell lung cancer patients.

Cao X, Li Y, Luo RZ, Zhang L, Zhang SL, Zeng J, Han YJ, Wen ZS - Sci Rep (2015)

Kaplan-Meier estimates of the probability of survival in patients with non-small cell lung cancer.(A) Disease-free survival (DFS) and (B) Overall survival (OS) curves for the whole cohort of patients with NSCLC; (C) DFS and (D) OS curves for the adenocarcinoma patients; (E) DFS and (F) OS curves for the SCC patients according the Cystatin SN protein expression level.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4316172&req=5

f3: Kaplan-Meier estimates of the probability of survival in patients with non-small cell lung cancer.(A) Disease-free survival (DFS) and (B) Overall survival (OS) curves for the whole cohort of patients with NSCLC; (C) DFS and (D) OS curves for the adenocarcinoma patients; (E) DFS and (F) OS curves for the SCC patients according the Cystatin SN protein expression level.
Mentions: All patients were included in the survival analysis. The median follow-up period was 41.5 months. A total of 67 patients were alive and 107 cancer-related deaths had occurred at the time of the last clinical follow-up. The five-year survival probability was 22% for the high Cystatin SN expression subgroup and 48% for the low Cystatin SN expression subgroup. According to the Kaplan-Meier analysis, the expression level of Cystatin SN was significantly associated with DFS and OS. For the full cohort, the median DFS was longer in patients with low Cystatin SN expression compared with those with high Cystatin SN expression (36 months vs. 15 months, P < 0.001) [Fig. 3(A)]. The median OS was 63 months for patients with low Cystatin SN expression and 36 months for patients with high Cystatin SN expression (P = 0.001) [Fig. 3(B)]. Furthermore, when we carried out the survival analyses in each histology subgroup, the benefit of low Cystatin SN expression was significant in patients with adenocarcinoma (DFS, 32 vs. 13 months, P = 0.004; OS, 63 vs. 24 months, P = 0.005) [Fig. 3(C–D)], whereas OS duration was similar between high and low-Cystatin SN expression subsets in SCC patients (57 vs. 46 months, P = 0.094) [Fig. 3(E–F)]. To determine whether Cystatin SN protein expression could serve as an independent prognostic parameter, we examined DFS and OS using univariate and multivariate Cox proportional hazards models. The results revealed that Cystatin SN expression (DFS, P = 0.001; OS, P = 0.006), pTNM stage (DFS, P < 0.001; OS, P < 0.001) and adjuvant chemotherapy (DFS, P < 0.001; OS, P < 0.001) were independent, significant predictors of DFS and OS. The details of these results are presented in Table 3 and Table 4.

Bottom Line: Disease-free survival (DFS) and overall survival (OS) were significantly prolonged in the low-Cystatin SN expression subgroup compared with the high-Cystatin SN expression subgroup (DFS, P < 0.001; OS, P = 0.001).A multivariate analysis confirmed that high expression of Cystatin SN was associated with poor survival (DFS, P = 0.001; OS, P = 0.006) and was an independent prognostic indicator.The present study indicates that high expression of Cystatin SN is a significant prognostic indicator of a higher rate of recurrence, metastatic risk, and poor survival in patients with surgically resected NSCLCs.

View Article: PubMed Central - PubMed

Affiliation: Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China.

ABSTRACT
Cystatin SN has been considered to be involved in human cancer, but its clinical significance in non-small cell lung cancer (NSCLC) has not been elucidated. The aim of this study was to evaluate the clinical value of Cystatin SN expression in patients with surgically resected NSCLCs. A retrospective analysis of 174 patients with surgically resected NSCLCs from April 2002 to March 2005 was performed with immunohistochemistry and fluorescence in situ hybridization to analyze the protein expression and amplification of Cystatin SN. The associations between Cystatin SN expression and recurrence, metastasis, and survival were investigated. In recurrence and metastasis analysis, compared with low-Cystatin SN expression NSCLCs, high expression tumors were more likely to recur and metastasize (P < 0.001). Disease-free survival (DFS) and overall survival (OS) were significantly prolonged in the low-Cystatin SN expression subgroup compared with the high-Cystatin SN expression subgroup (DFS, P < 0.001; OS, P = 0.001). A multivariate analysis confirmed that high expression of Cystatin SN was associated with poor survival (DFS, P = 0.001; OS, P = 0.006) and was an independent prognostic indicator. The present study indicates that high expression of Cystatin SN is a significant prognostic indicator of a higher rate of recurrence, metastatic risk, and poor survival in patients with surgically resected NSCLCs.

Show MeSH
Related in: MedlinePlus