IMMUNOHISTOCHEMICAL STUDY ON 543 CASES WITH MONOCLONAL ANTIBODIES AGAINST HUMAN LUNG CANCER

Three hybridized cell line. F- 19. N-35 and SIA-2 which secrete monoclonal antibodies (McAbs) against human lung cancer have been established by using the cell fusion technique. The three cell lines have been cultured in vitro for 14 to 16 months and can produce Monoclonal Antibodies steadily. With the three monoclonal antibodies, the immunohistochemistry technique has been applied to detect different histocytes from human lung cancer, various normal or abnormal tissues and organs. The potency that the monoclonal antibodies will be applied in clinic has also been studied.

PTEN and Ki67 expression is associated with clinicopathologic features of non-small cell lung cancer

Phosphatase and tensin homolog deleted on chromosome 10（PTEN） and the proliferating antigen Ki67 have been widely studied in several tumors.However,their role as indicator in non-small cell lung cancer（NSCLC）remains unknown.Here,we investigated the expression of PTEN and Ki67 in NSCLC tissues and paired normal lung tissues to identify whether these proteins are associated with lung cancer development and survival.Immunohistochemistry for PTEN and Ki67 was performed on 67 lung cancer tissues and 41 paired adjacent normal lung tissues to detect the expression of these two proteins.The expression of PTEN in NSCLC tissues（32.8%） was significantly lower than that in normal tissues（82.9%,P 〈 0.05）.In contrast,the expression of Ki67 in NSCLC tissues（76.1%） was significantly higher than that in normal tissues（27.3%,P 〈 0.05）.Expression of both PTEN and Ki67 were strongly associated with tumor histology,clinical stage,lymph node metastasis,differentiation and4-year postoperative survival rate（P 〈 0.05）.However,PTEN expression was negatively correlated with Ki67 expression（r =-0.279,P 〈 0.05）.In conclusion,low PTEN expression and Ki67 overexpression are associated with malignant invasion and lymph node metastasis of NSCLC.These proteins may serve as diagnostic and prognostic biomarkers of NSCLC.

Expression of Nerve Growth Factor and Hypoxia Inducible Factor-1α and Its Correlation with Angiogenesis in Non-Small Cell Lung Cancer

Summary： In order to investigate the expression of nerve growth factor （NGF） and hypoxia inducible factor-1α （HIF-1α） and its correlation with angiogenesis in non-small cell lung cancer （NSCLC）, paraffin-embedded tissue blocks from 20 patients with NSCLC were examined. Twenty corresponding para-cancerous lung tissue specimens were obtained to serve as a control. The expression of NGF, HIF-1α, and vascular endothelial growth factor （VEGF） in the NSCLC tissues was detected by using immunohistochemistry. The microvascular density （MVD） was determined by CD31 staining. The resuits showed that the expression levels ofNGF, HIF-1α and VEGF in the NSCLC tissues were remarkably higher than those in the para-cancerous lung tissues （P〈0.05）. There was significant difference in the MVD between the NSCLC tissues （9.19±1.43） and para-cancerous lung tissues （2.23±1.19） （P〈0.05）. There were positive correlations between NGF and VEGF, between HIF-1α and VEGF, and between NGF and HIF-1α in NSCLC tissues, with the spearman correlation coefficient being 0.588, 0.519 and 0.588, respectively. In NSCLC tissues, the MVD had a positive correlation with the three factors （P〈0.05）. Theses results suggest that NGF and HIF-1α are synergically involved in the angiogenesis of NSCLC.

Expression of Heat Shock Protein 70 and 27 in Non-small Cell Lung Cancer and Its Clinical Significance

The heat shock proteins （HSPs） 70 and HSP 27 expression in patients with non-small cell lung cancer （NSCLC） was studied and the relation.ship between HSP 70 and HSP 27 with the clinicopathological features of NSCLC was investigated. The expression of HSP 70 and HSP 27 was detected in tumor tissues from 60 patients with NSCLC by S-P immunohistochemistry. The findings were analyzed in combination with the histological types, histopathological differentiation, lymph node metastasis, patients＇ clinical stages, smoking history and gender. The results showed that of the 60 NSCLC tissue specimens studied, the immunoreactivity of HSP 70 and HSP 27 was detected in 47 （78.3 %） and 43 （71.7 %） specimens, respectively. A positive correlation was found between the overexpression of HSP 70 and HSP 27. The histopathological differentiation, lymph node metastasis, clinical stages and smoking history were correlated to the expression of HSP 70, but not to the expression of HSP 27. No statistical significance was observed in histological types and gender with respect to both HSP 70 and HSP 27 expression. It is suggested that the HSP 70 expression is a powerful and significant prognostic indicator and is related to histopathological differentiation, lymph node metastasis, patients＇ clinical stages, smoking history, whereas HSP 27 expression is not.

The expression of Elf-1 and Ki-67 and their correlations in non-small-cell lung cancer

Objective: Elf-1 is a member of the proto-oncogenes Ets-related transcription factor family and over-expressed in many human tumors, Ki-67 is an important nuclear antigen associated with cell proliferation. This study investigated the expression of Elf-1 and Ki-67 in non-small-cell lung cancer(NSCLC) and studied their correlation with the clinicopathological features. Methods: Tissue microarray from 64 cases lung cancer tissue and 10 cases normal lung tissue was constructed, immunohistochemical method was used to evaluate the protein expressions of Elf-1 and Ki-67, correlations of the expression of Elf-1 and Ki-67 to clinicopathological features of NSCLC were analyzed. Results: Expression of Elf-1 and Ki-67 in NSCLC tissues were significantly higher than in normal lung tissues(P < 0.05), the positive rate of Elf-1 and Ki-67 was 73.44% and 64.06% in NSCLC group, Overexpression of Elf-1 in NSCLC was significantly related to histopathological grading, different clinical staging and the intensity of ELF-1 expression was significantly higher in the group with lymph node metastasis than that without(P < 0.05). Overexpression of Ki-67 was also closely related to tumor differentiation, clinical stages and lymph node metastasis(P < 0.05). In addition positive correlation was found between the expressive intensity of Elf-1 and Ki-67(τ = 0.295, P = 0.018). Conclusion: The high expression and positive correlation of Elf-1 and Ki-67 in NSCLC suggest that they probably play a role in onset and progression of lung cancer, united detecting their expression could be used as an valuable molecular biological index for predicting the malignant behavior and early diagnosis of NSCLC.

Correlation and Significance of Midkine and Estrogen Receptor Beta Protein Expression in Non-Small Cell Lung Cancer

OBJECTIVE Midkine (MK),a new member of the heparin-binding growth factor family,was found recently to have a highexpression level in many carcinoma specimens,including thoseof the esophagus,gall bladder,pancreas,colorectum,breast andlung.Estrogen receptor beta (ER-β),a recently cloned estrogenreceptor subtype,was also found to be highly expressed in lungtumor tissue,in contrast to a lower level of expression in normallung tissue.However,few relevant studies on these proteins havebeen published.The aims of our study were to investigate theexpression of midkine and ER-β proteins in non-small cell lungcancer (NSCLC) and to examine the relationship between theirexpression and the clinicopathologic data as well as to analyse thecorrelation of their expression in NSCLC.METHODS By immunohistochemistry,MK and ER-β were ex-amined in 24 surgically resected cases of NSCLC with their corre-sponding paraneoplastic and normal lung tissues.RESULTS MK and ER-β were overexpressed in NSCLC.Thelevels of MK and ER-β expression in NSCLC were found to be sig-nificantly negatively correlated with the pathological classification(P=0.042 and 0.021,respectively),and their expression decreasedwith a raise in the classification.Spearman's correlation analysisshowed that the correlation of their expression in NSCLC wasstrong (correlation coefficient[r_s]= 0.535,P=0.007<0.01).CONCLUSION The expression levels of MK and ER-β to someextent reflect the malignant degree of NSCLC,and their combineddetection may be of great value in early diagnosis,treatments ofpatients with NSCLC and can predict the prognoses.

Expression of Coxsackievirus and Adenovirus Receptor in Human Lung Cancer： Possible Clinical Significance

OBJECTIVE To explore the relationship between CAR and the development of human lung cancer, as well as to provide the basis for the clinical treatment of lung cancer using an adenovirus vector-based gene therapy. METHODS CAR expression was assessed immunohisto- chemically in tumoral, paraneoplastic and normal samples from 112 lung cancer patients. At the same time, the mRNA and protein expression of CAR in 32 cases were determined by RT-PCR and Western blot. The relationship between CAR expression and clinicopathologic parameters was statistically analyzed. RESULTS There was no expression of CAR in normal lung tissue but a little in paraneoplastic tissue. The positive rate was 43% in squamous cell carcinoma, and 70% in adenocarcinoma. Both were much significantly higher than that in paraneoplastic tissue. The CAR expression level in adenocarcinoma was higher than that in squamous cell cancer, mRNA expression by RT-PCR and protein expression by Western blot were consistent with immunohistochemistry results. CONCLUSION CAR is overexpressed in human lung cancer, especially in adenocarcinoma. This data offer the reliable basis for adenovirus-mediated gene therapy of lung cancer; more important, CAR may take part in the formation or development of lung cancer; this may be exploitable for the development of antibody-directed therapy in human lung cancer.

Breast metastasis from lung cancer：a report of two cases and literature review

Breast metastasis from extra-mammary malignancy is rare. An incidence of 0.4% to 1.3% has been reported in literature. The primary malignancies that most commonly metastasize to the breast are leukemia, lymphoma, and malignant melanoma. In this report, two cases of pulmonary metastasis to the breast were presented. A 40-year-old female manifested a right breast mass of 2-month duration. After physical examination was performed, a poorly defined mass was noted in the upper outer quadrant of the right breast. Another 49-year-old female manifested right breast mass of 5-day duration. A poorly defined mass was noted in the lower inner quadrant of the right breast. Mammography results also revealed breast cancer. The patients underwent local excision. After histological and immunohistochemical analyses were conducted, a primary lung carcinoma that metastasized to the breast was diagnosed. An accurate differentiation of metastasis to the breast from primary breast cancer is very important because the treatment and prognosis of the two differ significantly.

Abnormal expression of VEGF and its gene transcription status as diagnostic indicators in patients with non-small cell lung cancer

Objective Angiogenesis is known to be essential for the survival,growth,invasion,and metastasis of lung cancer cells. Vascular endothelial growth factor(VEGF) is an important factor regulating angiogenesis of non-small cell lung cancer(NSCLC); however,its pathologic features and significance are unclear. In this study,the tissue VEGF expression levels and its gene transcriptional status,as well as circulating VEGF levels,were investigated in patients with lung disease. Methods VEGF protein and m RNA expression levels in 38 lung tissue samples were analyzed by immunohistochemistry and reverse transcription-polymerase chain reaction(RT-PCR),respectively. Circulating VEGF levels were detected quantitatively by an enzyme linked immuno-sorbent assay. Results The level of VEGF expression was significantly higher in lung cancer tissue than in the corresponding paracancerous or non-cancerous tissues. The average level of VEGF-positive staining was 76% in tissue samples from NSCLC patients; the levels were 89% in tissue samples from stage III patients and 92% in stage IV patients. High VEGF expression was also evident in cases with lymph node metastasis(84%),distant metastasis(90%),and lower differentiation degree(89%). VEGF m RNA in cancerous tissues was represented predominantly by the VEGF121 and VEGF165 isoforms. Circulating VEGF levels were significantly higher in NSCLC patients [(840 ± 324) pg/m L] than in patients with benign lung diseases [(308 ± 96) pg/m L] or in healthy individuals serving as controls [(252 ± 108) pg/m L]. Conclusion The over-expression of lung VEGF and its gene transcription status should be useful molecular indicators for NSCLC diagnosis.

A case of small intestinal hemorrhage secondary to metastatic lung cancer in the elderly

Gastrointestinal metastasis from primary lung cancer is rare. In the present study, we report the case of a 78-year-old male who was admitted to the emergency department with acute bleeding of the digestive tract. During evaluation, he was found to have lung adenocarcinoma metastasis in the small bowel leading to hemorrhage. A jejunum wedge resection was carried out and bleeding was controlled. However, 2 months after the operation, the patient died from severe pulmonary infection. We also review the published literature of primary lung cancer with gastrointestinal metastasis.

Expressions of Livin and Smac Proteins in Non-Small Cell Lung Cancer

Objective： To investigate the expression characteristics of Livin and second mitochondrial activator of Caspase （Smac） proteins in non-small cell lung cancer （NSCLC）, and analyze their effect on patients＇ prognosis. Methods： The expressions of Livin and Smac proteins were detected in 89 NSCLC tissue samples and 25 normal lung tissue samples by immunohistochemical technique. Results： The positive expression rates of Livin and Smac proteins in NSCLC tissues were 53.9%, and 58.4% respectively, higher than that in normal lung tissues（P〈0.01）. Livin protein expression correlated with Smac protein significantly（Χ^2=1 8.451, P=0.000, r=0.455）. The expression level of Livin protein was closely related to lymph node metastasis, TNM stage and histological type （P〈0.05）, but not to sex, age, differentiation grade （P〉0.05）. The expression level of Smac protein was closely related to lymph node metastasis, TNM stage （P〈0.01）, but not to sex, age, histological types （P〉0.05）. Kaplan-Meier analysis revealed a significant impact on survival by Livin protein in NSCLC （P〈0.01）, but not by Smac protein （P〉0.05）. Conclusion： Overexpression of Livin protein may play a promoting role in the occurrence and progression of NSCLC. Moreover, it may bring an adverse effect on patients＇ prognosis. Although overexpression of Smac protein affects the occurrence and progression of NSCLC, it has no relationship with the prognosis. Livin protein may be helpful to evaluate the progression of NSCLC, and to predict the prognosis.

EXPRESSION OF FRAGILE HISTIDINE TRIAD AND P53 IN NON-SMALL CELL LUNG CANCER

Objective： To investigate the expression offragile histidine triad （FHIT） and p53 protein in non-small cell lung cancer （NSCLC） and explore the relationship between their expressions and the clinicopathological features. Methods： FHIT protein and p53 protein were detected by immunohistochemistry in 76 cases of NSCLCs and matched normal lung tissues. Results： Fifty-one cases （67.1%） showed negative expression of FHIT （apparent reduction or loss） and thirty-seven cases （48.7%） showed p53 positive expression （overexpression）. The difference was significant （P=0.04）. However, there was no significant difference in FHIT expression between the p53-positive group and the p53-negative group （64.9% versus 69.2%, P=0.686）. The negative rate of FHIT protein expression was higher in squamous cell carcinoma than in adenocarcinoma, in moderately and poorly differentiated carcinoma than in well-differentiated carcinoma, and in cases with smoking history than in cases without smoking history （P〈0.05）. There was no relationship between FHIT expression and clinical stage or lymph node metastasis. The negative FHIT expression was not an independent predictor of overall survival （P=0.338）. Conclusion： The frequency of negative expression of FHIT protein is higher than that of positive expression of p53 in NSCLCs. The negative expression of FHIT is independent of the expression of p53. The change of expression of FHIT may play a role in the smoking related lung tumorigenesis while it may have no relationship with the progress of NSCLC or prognosis of the patients.

EXPRESSION OF P120ctn IN NON-SMALL-CELL LUNG CANCER: A CLINICOPATHOLOGICAL STUDY

Objective: To investigate the expression of p120ctn in non-small-cell lung cancer (NSCLC) and its relationship with clinicopathological factors and prognosis. Methods: p120ctn expression was tested by immunohistochemistry for 80 tumors from patients with non-small-cell lung cancer. Correlations were investigated between p120ctn immunostaining in primary tumors and clinicopathological characteristics and survival. Results: Abnormal expression of p120ctn was found in 68/80(85%) tumors in which 43 cases had cytoplasmic staining. Abnormal staining of p120ctn was related with high TNM stage (P=0.003) and nodal metastasis (P=0.024). However, there was no correlation between altered expression with poor differentiation and histological type. According to Kaplan-Meier survival estimate, the expression of p120ctn was related to the poor survival (P=0.015) of patients. A Cox regression analysis revealed that p120ctn expression was a significant independent factor in the prediction of survival for patients with non-small-cell lung cancer (P=0.008). Conclusion: altered expression of p120ctn was found in non-small-cell lung cancers and was correlated with lymph node metastasis and prognosis. From a practical point of view, the expression of p120ctn can be of prognostic value for patients with non-small-cell lung cancer.

Nm23 GENE EXPRESSION AND ITS CORRELATION WITH LYMPH NODE METASTASIS IN HUMAN LUNG CANCER

Using labelled streptavidin-biotin (LSAB) method,we examined the expression of nucleoside diphosphate (NDP) kinase, the product of metastasis suppressor gene nm23, in human lung cancer. Of 88 patients tested, 48(54.5%) showed positive staining. The Positive staining rate was higher in adenocarcinoma (28/42, 66.7%) than in squamous cell carcinoma (20/46, 43.5%; P<0.05).Higher incidence of positve staining wasalso found in squamous cell carcinomas without hilar or mediastinal lymph node metastasis (16/27, 59.3%) than in those with hilar or mediastinal lymph node involvement (4/19, 21.1 %;P<0.05). NDP kinase/nm23 was equally expressed in adeno-carcinoma, irrespective of lymph node status. In both cell types of carcinoma, expression of NDP kinase/nm23 was not correlated with tumor cell differentiation, nor was it correlated with the P-TNM staging. Our results suggest that NDP kinase/nm23 may play different roles in the pathogenesis and metastasis of human pulmonary squamous cell carcinoma and adenocarcinoma. Its expression levels are inversely correlated with lymph node metastasis of squamous cell carcinoma of the lung.

Expression and correlation of Ezrin and survivin in non-small cell lung cancer

Objective: The aim of this study was to explore expression and correlation of Ezrin and survivin in non-small cell lung cancer (NSCLC). Methods: Expression of Ezrin and survivin were detected and analyzed by Envision method of immu- nohistochemical staining in 86 NSCLC. Results: The strong expression rate of Ezrin in NSCLC was 60.5% and significantly correlated with lymph node metastasis (P < 0.05), but no associated with gender, histologic subtype, TNM stages, differen- tiation and smoking. Meanwhile, the positive expression rate of survivin in NSCLC was 65.1% and significantly correlated with TNM stages and lymph node metastasis (P < 0.05), but no associated with gender, histologic subtype, differentiation and smoking. And expression of Ezrin and survivin were positively correlated in NSCLC (r = 0.384). Conclusion: Ezrin and survivin may play synergetic roles in the process of carcinogenesis of NSCLC, and their expression may be significantly associated with NSCLC metastasis. Detection of Ezrin and survivin may be valuable for diagnosing lung cancer metastasis and providing evidence for clinical treatment.

Expression of EphB4 and HIF-1α in lung cancer and its clinical significance

Objective： To investigate the relationship between the expression of EphB4 and HIF-la in lung cancer and their biological significance. Methods： The expression of EphB4 and HIF-1α was detected in 54 specimens of lung cancer by using streptavidin-peroxidase （SP）immunohistochemical method, and 10 normal lung tissues as control. Results： Among the 54 cases of lung cancer, the positive rate of EphB4 was 50.0%; 42.6% of the tumors were positive for HIF-1α. The expression of these two kinds of proteins was related to gross types, differentiation and clinical stages （P〈0.05）, but not to histological classification, age, sex and lymphoid metastasis （P〉0.05）. A highly positive correlation was observed between the expression of EphB4 and HIF-1α （P〈0.01）. Conclusion： Overexpression of EphB4 and HIF-1α may play an important role in the pathogenesis, progression and malignant degree of lung cancer. Detection of EphB4 and HIF-1α expression might be helpful to predict prognosis of patients with lung cancer.

Expression of coxsackie and adenovirus receptor in small cell lung cancer

Objective: We explored the expression of coxsackie and adenovirus receptor (CAR) in small cell lung cancer (SCLC) tissue. Methods: CAR expression in 31 SCLC was assessed in formaldehyde-fixed, paraffin-embedded tissue according to the EnVision immunohistochemistry procedure, while 3 samples of surgical specimens of non-malignant lung disease were taken as the negative control. Results: We observed that the expression of CAR was detectable positive in all the 31 cases from the small cell lung cancer tissue, in contrasting that non-malignant lung tissue control. Conclusion: The high expression of CAR appeared in SCLC tissue indicates that it play an important role in of adenovirus vector-based gene therapy in SCLC.

The preparation of anti-hnRNP A2/B1 polyclonal antibody and its potential application in non-small cell lung cancer

Objective： In order to evaluate potential application for diagnosis and prognosis of non-small cell-lung cancer （NSCLC）, as well as to determine its role in the pathogenesis of the disease, we prepared anti-human hnRNPA2/B1 potyclonal antibody. Methods： Prokaryotic expression vector of pET28a （＋）-hnRNP A2/B1 was constructed and bansformed into E.coli BL21. The recombinant protein induced by IPTG was purified and injected to rabbits for antibody preparation. Expression of hnRN P A2/B1 was examined in 45 tissues of NSCLC and 16 inflammatory pseudotumor tissues of lung by immunohistochemistry with the antibody. The commercial hnRNP A2/B1 monoclonal antibody was used as a controI.Results： （1） Polyclonal an-tibody against hnRNP A2/B1 with high title was obtained. （2） The positive staining in NSCLC tissues was 62.22%, which was substantially higher than that in normal tissues （40%, P = 0.035） or inflammatory pseudotumor tissues （31.25%, P=0.033）. （3） Expression of hnRNP A2/B1 positively correlated with age and the history of smoking, whereas it negatively correlated with differentiation staging of tumors. （4） Follow-up study showed that the survival time of patients with positive staining was significantly shorter than that of patients without hnRNP A2/B1 expression （P=0.048）. Conclusion： It is successful to make the recombinant protein and prepare the polyclonal antibody agonist human hnRNP A2/B1. It may be a valuable marker for the diagnosis and prognosis of NSCLC. Our results provide a basis for further study in clinical application.

Effects of gemcitabine and cisplatin chemotherapy in advanced non-small cell lung cancer patients with RRM1 low protein expression

Objective： The aim of this study was to observe the efficacy of gemcitabine combined with cisplatin （GP） in advanced non-smaU cell lung cancer （NSCLC） patients with low expression of ribonucleotide reductase 1 （RRM1） protein using immunohistochemistry. Methods： RRM1 protein expression in tumor tissue was detected by streptavidin-peroxidase （SP） method of immunohistochemistry. GP regimen （gemcitabine 1000-1250 mg d1, d8, cisplatin 75 mg/m2） was given to advanced NSCLC patients with low expression of RRM1 protein. Results： In the total of 40 patients, these patients with RRM1 low expression performing GP chemotherapy had a good response rate, the objective response rate （ORR） was 47.5% （95% CI, 32.02%- 62.98%）, and the disease control rate （DCR） was 72.5% （95 % CI, 65.44%-79.56%）. ORR is 45.45% （5/11） in the squamous cell carcinoma patients while 48.15% （13/27） in the adenocarcinoma patients. Conclusion： Supedor ORR and DCR were found in advanced NSCLC patients with low expression of RRM1 protein expression performing GP regimen.