Author of

• 12701

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  P3.12 - Poster Session 3 - NSCLC Early Stage (ID 206)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Medical Oncology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12722

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    P3.12-021 - The role of pentraxin 3, an acute phase protein, and of smoldering inflammation at the tumor site in lung cancer progression and prognosis. A clinicopathologic study (ID 3290)

    09:30 - 09:30  |  Author(s): A. Morlacchi
    • Abstract

    Background
    The prognosis remains dismal for most lung cancer patients, even for early cases, suggesting the existence of sophisticated pathogenetic mechanisms that are not reflected by pathological stage. Although a number of studies have been carried out in relatively recent times [], our understanding of the role and clinical significance of inflammation and immunity in human lung cancer is still limited. We investigated in detail the diagnostic and prognostic role of two acute phase proteins, Pentraxin 3 (PTX3) and C-reactive protein (CRP), in high-risk subjects and lung cancer patients.

    Methods
    A cohort of high-risk, cancer-free subjects enrolled in a lung cancer early-detection trial with spiral CT, a group of screening-detected lung cancer patients, and two groups of consecutive non-small cell lung cancer patients admitted to our Thoracic Surgery Department between January 2009 to June 2010 were included. Serum CRP and PTX3 levels were determined in the high-risk, healthy cohort (N=1434) and in patients with non-small cell lung cancer. Pre-treatment blood samples were prospectively collected prior to surgical resection in lung cancer patients. PTX3 expression was determined by immunohistochemistry and scored using semiquantitatively. Survival curves were calculated by the method of Kaplan and Meyer. Prognostic factors were analyzed by multivariate Cox regression.

    Results
    No significant association was found between PTX3 or CRP serum levels and the risk of subsequently developing lung cancer or any malignancy in the high-risk-cohort. 119 patients harbouring 124 primary lung cancers were evaluable. Screening and clinically detected lung cancer patients were comparable as to age and comorbidity. There was a significantly higher rate of stage I disease among screening patients (p=0.01). Preoperative serum CRP and PTX3 levels in lung cancer patients were significantly higher than in the tumour-free, high-risk population, p<0.001). In the tumour stroma, PTX3 expression was low or moderate in 55% and intense in 10%. Tumour cells stained weakly positive in 24%. Staining for PTX3 was virtually absent in the normal lung interstice. Median follow-up was 27 months (0-140), Median 2-year disease-free survival was 71 % and median overall 2-year survival was 75% Preoperative serum levels of CRP and PTX3 did not correlate with survival. Instead, age (p=0.029), stage (p=0.001) and interstitial PTX3 expression (p<0.001) were independent prognostic factors

    Conclusion
    PTX3 and CRP levels are not linked to a higher risk of developing lung cancer or any cancer in a healthy high-risk population. Nonetheless, mean CRP and PTX3 concentrations in patients with lung cancer are significantly higher than in the blood of healthy high risk subjects, and a significant and independent correlation was found for interstitial PTX3 expression with lung cancer prognosis after surgery. Altogether this data suggests a connection between smoldering inflammation in the tumor bed and lung cancer progression that warrants further investigation.