Loss of alpha v integrin expression and recurrence in node-negative lung carcinoma

Background. Despite ''curative'' resection, metastases develop in many patients with node-negative (NO) nonsmall cell lung carcinoma. Alternative biologic markers for this tumor would be useful. Integrins are cell adhesion molecules that are thought to be important in tumor progression, and expression of these molecules previously has been shown to be altered in non-small cell lung carcinoma. We evaluated alterations in integrin expression and clinical outcome. Methods. Immunohistochemical staining of tumor specimens was performed, and clinical data were reviewed retrospectively. Results. Data were complete for 42 patients. Half of all patients (21/42) and 9 of 26 patients with negative nodes experienced tumor recurrence during follow-up. Neither histologic type nor tumor differentiation status correlated with recurrence. However, loss of the alpha v integrin subunit was associated significantly with recurrence in the NO group. Seventy-five percent of patients with negative nodes who exhibited recurrence lost alpha v expression, compared with only 10% of patients with negative nodes who did not exhibit recurrence (p = .0.012). Alterations of other integrin subunits did not correlate significantly with prognostic follow-up variables. Conclusions. Loss of alpha v expression may serve as a marker for patients with node-negative non-small cell lung carcinoma who are at high risk for recurrence, potentially directing additional therapies. (C) 1997 by The Society of Thoracic Surgeons.