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Japanese Journal of Clinical Oncology Advance Access published online on September 4, 2008
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyn089
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© 2008 The Author(s)
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Low Expression of Bax Predicts Poor Prognosis in Resected Non-small Cell Lung Cancer Patients with Non-squamous Histology{dagger}

Seong Hyun Jeong1, Hyun-Woo Lee1, Jae Ho Han2, Seok Yun Kang1,3, Jin-Hyuk Choi1,3, Youn Mu Jung1, Ho Choi4, Young Taek Oh3,5, Kwang Joo Park3,6, Sung Chul Hwang3,6, Seung Soo Sheen3,6,7, Yoon Jung Oh3,6, Jang Hee Kim2 and Ho-Yeong Lim8

1 Department of Hematology-Oncology
2 Department of Pathology
3 Lung Cancer Center
4 Department of Chest Surgery
5 Department of Radiation Oncology
6 Department of Pulmonary and Critical Care Medicine
7 Section of Clinical Epidemiology and Biostatistics in Clinical Trial Center, Ajou University School of Medicine, Suwon
8 Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

For reprints and all correspondence: Jin-Hyuk Choi, Department of Hematology-Oncology, Ajou University School of Medicine, Suwon 443-721, Republic of Korea. E-mail: jhchoimd{at}ajou.ac.kr

Received June 11, 2008; accepted August 2, 2008

Objective: The present study evaluated the prognostic significance of apoptosis-related proteins p53, Bax and galectin-3 in patients with non-small cell lung cancer (NSCLC) treated with surgical resection.

Methods: We investigated the expression of these proteins and their association with clinicopathologic characteristics including disease-free survival (DFS) and overall survival (OS) in 205 NSCLC patients who underwent surgical resection (Stage I, 97; II, 46; IIIA, 45; IIIB, 17) using immunohistochemistry. Eighty-eight patients (43%) received adjuvant treatment (chemotherapy: 8, radiotherapy: 24, both: 56).

Results: High expressions of Bax, p53 and galectin-3 were observed in 48 (23%), 81 (40%) and 105 (51%) patients, respectively. Low expression of Bax was significantly associated with male gender, squamous cell histology and low expression of galectin-3. Five-year DFS and OS of total patients were 37 and 46%, respectively. High expressions of p53 and galectin-3 were not associated with poor DFS or OS, and no significant correlation existed between low expression of Bax and outcome of patients. However, in patients with non-squamous histology (108 patients), low expression of Bax was a significant independent predictor of poor DFS (P = 0.017) and OS (P = 0.037). In addition, in patients with Stage II or III disease, low expression of Bax significantly correlated with poor DFS (P = 0.004). It was also the most significant independent poor prognostic factor second only to a large primary tumor size in Stage II or III patients with non-squamous histology.

Conclusions: Low expression of Bax was significantly associated with poor prognosis in resected NSCLC patients with non-squamous histology.

Key Words: non-small cell lung cancer • Bax • prognosis

{dagger} Presented in part at the 42nd Annual Meeting of American Society of Clinical Oncology, Atlanta, Georgia, 2006.


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