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Original Research: LUNG CANCER |

Prognostic Significance of Nestin Expression in Resected Non-small Cell Lung Cancer

Shinichiro Ryuge, MD; Yuichi Sato, PhD; Guo Qin Wang, MD; Toshihide Matsumoto, MS; Shi Xu Jiang, MD; Ken Katono, MD; Hayato Inoue, MD; Yukitoshi Satoh, MD; Noriyuki Masuda, MD, FCCP; International Association for the Study of Lung Cancer International Staging Committee
Author and Funding Information

From the Department of Respiratory Medicine (Drs Ryuge, Katono, and Masuda); Kitasato Clinical Research Center (Dr Wang); the Department of Pathology (Dr Jiang); and the Department of Thoracic and Cardiovascular Surgery (Dr Satoh), School of Medicine; the Department of Molecular Diagnostics (Dr Sato), School of Allied Health Sciences; the Department of Cellular and Histo-Pathology (Mr Matsumoto), Graduate School of Medical Sciences, Kitasato University; and the Department of Thoracic Surgery (Dr Inoue), National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan.

Correspondence to: Yuichi Sato, PhD, Department of Molecular Diagnostics, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan; e-mail: yuichi@med.kitasato-u.ac.jp


Funding/Support: This study was funded in part by Grants-in-Aid for Scientific Research C [C19590365] from the Japan Society for the Promotion of Science, and for Third Term Comprehensive Control Research for Cancer conducted by the Ministry of Health, Labour and Welfare of Japan, and Research Project [No. 2009-1002] from the School of Allied Health Sciences and 2008-2009 Project Study from the Graduate School of Medical Sciences, Kitasato University.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;139(4):862-869. doi:10.1378/chest.10-1121
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Background:  Nestin is a class 6 intermediate filament protein expressed in stem/progenitor cells during CNS development. Nestin expression has been detected in many kinds of tumors and was reported in a recent small-scale study in non-small cell lung cancer (NSCLC). We investigated the relationships between nestin expression and clinicopathologic parameters and determined its prognostic significance concerning survival in patients with resected NSCLC.

Methods:  Nestin expression in tumor cells was studied immunohistochemically in 171 consecutive patients with NSCLC, and associations with clinicopathologic parameters were evaluated. Kaplan-Meier survival analysis and Cox proportional hazards models were used to estimate the effect of nestin expression on survival.

Results:  Nestin expression was observed in tumor cell samples in 27 of the 171 patients with NSCLC (15.8%). Nestin had only cytoplasmic expression. Clinicopathologically, nestin expression was significantly associated with squamous cell carcinoma (P = .001), poorer differentiation (P = .007), lymph node metastasis (P = .008), intratumoral vascular invasion (P = .003), intratumoral lymphatic invasion (P = .008), pleural invasion (P = .039), and poorer prognosis (P < .001). Multivariable analysis confirmed that nestin expression increased the hazard of death after adjusting for other clinicopathologic factors (hazard ratio, 2.75; 95% CI, 1.39-5.46).

Conclusions:  The present study suggests that nestin expression is a prognostic indicator of poorer survival probability for patients with resected NSCLC and may be used as a potential marker for select patients who should receive adjuvant chemotherapy.

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