Laminin, Her2/neu and Ki-67 as prognostic factors in non-small cell lung cancer
Szelachowska J, Jelen M

Purpose: The aim of this study was to determine the values of Ki-67 antigen, oncoprotein Her2/neu and laminin, as prognostic and predictive factors in NSCLC, and on the basis of these markers to create a prognostic model which would make it possible to identify patients with a high risk of disease recurrence.
Material and methods: The material for the study came from 64 patients with NSCLC, who underwent surgery in Dolnoslaskie Centrum Gruźlicy i Chorob Pluc i 1996--2000, and subsequently were given radiation therapy in Dolnoslaskie Centrum Onkologii.
Results: Among the markers researched, a high level of (intracellular) laminin in carcinoma cells was found to be an unfavourable prognostic factor. Also, another group of patients with an overexpression of oncoprotein Her2/neu were found to have a poorer prognosis, although the influence of proliferative index Ki-67 on patient survival could not be explained. The prognostic model LAMHER, which was defined on the basis of the intracellular laminin level and expression HER2/neu, enables the identification of a group of patients with a high risk of disease recurrence. In a multidimensional analysis of the “classification tree”, it was found that patients with the highest risk of disease recurrence were those with LAMHER=1 (overexpression Her2/neu and/or a high level of intracellular laminin), and patients with LAMHER=0 but a Fractionation Dilution Factor higher than 1.57.
Conclusions: The conclusion of this study is that multiple molecular marker testing is necessary to detect an independent prognostic impact on survival and is therefore superior to single marker testing. Based on LAMHER testing, two groups of patients could be defined: a low-risk group (LAMHER=0) and a high-risk group (LAMHER=1) for failure of standarized treatment.

Key words:   laminin, Her2/neu, Ki-67, non-small cell lung cancer, postoperative radiotherapy.