Original ContributionsPrognostic value of immunohistochemical expressions of p53, HER-2/neu, and bcl-2 in stage I non–small-cell lung cancer*
Section snippets
Patients
Eighty-five patients with stage I NSCLC who underwent either lobectomy or pneumonectomy at Allegheny General Hospital between December 1995 and January 1997 were selected in this study and followed up for 32 to 44 (median, 39.0; mean, 37.1) months postoperatively. Sections of the primary tumor from each case were fixed in 10% formalin and embedded in paraffin. The diagnosis of NSCLC and categorization of cell type were based on conventional morphologic criteria,31 and the histopathologic stage
Results
Figure 1 shows the staining of p53, HER-2/neu, and bcl-2 in tumors resected from stage I NSCLC using immunohistochemical methods.The dark brown color denotes positive staining. p53 protein is located in the nuclei of tumor cells, HER-2/neu protein is
Discussion
The key finding of the current study is that expression of p53 or HER-2/neu in stage I NSCLC is associated with poor prognosis, as are the presence of angiolymphatic invasion and tumor size > 3 cm. Patients whose tumors are positive for both p53 and HER-2/neu apparently have a worse outcome, and the worst outcome is seen in patients with more than 3 risk factors. bcl-2 does not seem to be a prognostic factor for overall survival, although it is seen more frequently in the squamous carcinomas.
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Address correspondence and reprint requests to Jan F. Silverman, MD, Departments of Pathology and Laboratory Medicine, Allegheny General Hospital, 320 East North Ave, Pittsburgh, PA 15212.