Prognostic Significance of Neuroendocrine Differentiation in Non-small Cell Lung Cancer Patients' Survival

Abstract

Objective: To observe the relationship between non-small cell lung cancer with neuroendrocrine differentiation (NSCLC-NE) and patients' postoperative survival. Methods: During April 1997 to April 1999, 98 cases of lung cancer were surgically treated. The tumor specimens of the patients were stained by NE markers, i.e. neuron specific enolase (NSE) and synaptophysin (SY). The intensity of NE markers reaction was divided as "+", "++", "+++" scale groups. The same specimens were also examined under an electron microscope for the specific neuroendocrine granules. All enrolled patients were followed up for 36 months, and the longest follow-up time was 60 months. The COX proportional hazard model multivariate analysis was applied to observe the relationship between the NSCLE-NE and the patients' postoperative survival. Results: In 91 cases of NSCLC, 63.7% (58/91) were positive for NE stain reaction. Among them, 59.3% (54/91) were positive for NSE and 24.1% (22/91) for SY. 48.4% (44/91) were considered as NSCLC-NE by the combination of NE marker stain reaction and electron microscopic examination. COX proportional hazard model multivariate analysis showed that the NSCLC-NE patients' survival was significantly shortened (P=0.048). The following factors were related to NSCLC-NE patients' survival: lung cancer cell differentiation (P=0.006), clinical lung cancer stage (P=0.001), the NE markers reaction (P=0.054). Conclusion: NSCLE-NE is significantly related to the cancer cell differentiation and the patients' postoperative survival. The NE markers should be applied clinically as one of prognostic factors to evaluate the postoperative survival of NSCLC patients.