Abstract
We have investigated the clinical importance of K- ras oncogene activation and the expression of the neural cell adhesion molecule (N-CAM) in a series of surgical resected lung carcinomas. In patients with inoperable disease we correlated pretreatment levels of serum neuron-specific enolase (NSE) and lactate dehydrogenase (LDH) with response to chemotherapy. The presence of K- ras point mutations and N-CAM expression, as measured by Mab 123C3 immunostaining, defined subgroups of patients with non-small cell lung cancer (adenocarcinoma) for whom the prognosis is poor and disease-free survival is not usually long despite radical resection. In the patients with inoperable disease high NSE and LDH levels correlated with an increased response (60%) to chemotherapy. The understanding of basic biologic characteristics of non-small cell lung cancer, i.e. K- ras point mutations and neuroendocrine differentiation, may aid in treatment selection and help to identify groups of patients that will benefit from adjuvant chemotherapy.
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