Expression of syndecan‐1 and expression of epidermal growth factor receptor are associated with survival in patients with nonsmall cell lung carcinoma

BACKGROUND Recently, the authors identified molecular signatures and pathways associated with nonsmall cell lung carcinoma histology and lung development. They hypothesized that genetic classifiers of histology would provide insight into lung tumorigenesis and would be associated with clinical outcome when evaluated in a broader set of specimens. METHODS Associations between patient survival and immunostaining for 11 representative histologic classifiers (epidermal growth factor receptor [EGFR], CDK4, syndecan‐1, singed‐like, TTF‐1, keratin 5, HDAC2, docking protein 1, integrin α3, P63, and cyclin D1) were examined using a tissue microarray constructed from nonsmall cell lung carcinoma specimens. RESULTS Sixty‐three tumors were examined, including 43 adenocarcinomas, 11 large cell carcinomas, and 9 squamous cell carcinomas. Sixty‐three percent of tumors were clinical Stage I lesions, and 37% were Stage II–III lesions. In a multivariate analysis that controlled for age, gender, and race, syndecan‐1 expression was found to be associated with a significant reduction in the risk of death (hazard ratio, 0.31 [95% confidence interval, 0.18–0.87]; P < 0.05). Multivariate analysis also indicated that EGFR expression was associated with a significant reduced risk of death. CONCLUSIONS The authors demonstrated that expression of either of the nonsmall cell lung carcinoma subtype classifiers syndecan‐1 and EGFR was associated with a 30% reduction in the risk of death, with this reduction being independent of histology and other confounders. The results of the current study suggest that loss of expression of these histologic classifiers is associated with biologic aggressiveness in lung tumors and with poor outcome for patients with such tumors. If their significance can be validated prospectively, these biomarkers may be used to guide therapeutic planning for patients with nonsmall cell lung carcinoma. Cancer 2004. © 2004 American Cancer Society. Expression of either of the nonsmall cell lung carcinoma histology classifiers, syndecan‐1 and epidermal growth factor receptor, on tissue microarray analysis was associated with a significant reduction in the risk of death, with this reduction being independent of histology and other confounders. The results of the current study suggest that loss of expression of these histologic classifiers is associated with biologic aggressiveness in lung tumors and with poor outcome for patients who have such tumors.