3 The abbreviations used are: LOH. loss of heterozygosity: SCLC. small
cell lung cancer: NSCLC, non-small cell lung cancer.
Vol. 2, 1185-1189, July /996 Clinical Cancer Research 1185
Loss of Heterozygosity at 3p in Non-Small Cell Lung Cancer and Its
Prognostic Implication1
Tetsuya Mitsudomi,2 Tsunehiro Oyama,
Kinue Nishida, Akira Ogami, Toshihiro Osaki,
Kenji Sugio, Kosei Yasumoto, Keizo Sugimachi,
and Adi F. Gazdar
Department of Surgery II, Faculty of Medicine, Kyushu University,
Fukuoka 812-82, Japan [T. M.. K. Sugio, K. Sugim.l; Department of
Surgery II, University of Occupational and Environmental Health,
School of Medicine, Kitakyushu 807, Japan fT. M., T. Oy., K. N.,
A. 0.. T. Os., K. Sugio. K. Y.1; and Hammon Cancer Center and
Department of Pathology. University of Texas, Southwestern Medical
Center. Dallas, Texas 75235-8593 [A. F. G.]
ABSTRACT
We examined 1 10 patients with non-small cell lung
cancer who underwent consecutive pulmonary resection for
loss of heterozygosity (LOH) at the short arm of chromo-
some 3 (3p). We performed a PCR-based microsatellite
polymorphism analysis for detection of LOH. The microsat-
ellite markers used were D3S966 (3p2l.3), D3S1007 (3p2l.3-
22), and D3S1228 (3pl4.l-l’L3). Of 98 informative cases, 3p
LOH was found in 45 (46%). 3p LOH was more prevalent in
squamous cell carcinoma (24/35, 69%) than in adenocarci-
noma (18/52, 35%; P 0.0019). There was no significant
association between 3p LOH and sex, disease stage, or grade
of differentiation. However, patients with 3p LOH tended to
survive for a shorter period of time (P = 0.0631, log rank
test). There was no such tendency in squamous cell carci-
noma (P = 0.7513), but in adenocarcinoma, the difference of
survival was significant (P = 0.0015). Cox’s proportional
hazards model also predicted that 3p LOH was an independ-
ent poor prognostic marker in adenocarcinoma (P = 0.0502)
but not in squamous cell carcinoma or in the entire cohort
(P = 0.7866 and 0.1371, respectively). LOH at 3p may help
to identify non-small cell lung cancer patients with a poor
prognosis, who thus need an intensive postoperative fol-
low-up protocol or who are suitable for novel investigational
therapeutic approaches. It is also suggested that the putative
tumor suppressor gene at 3p may have a different role in
squamous cell carcinoma and adenocarcinoma of the lung.
Received 1 1/20/95; revised 1/3 1/96; accepted 3/27/96.
I This work was supported in part by Grants-in-Aid 0445435 1 and
07457300 from the Ministry of Education, Science and Culture in Japan
and by grants from the Fukuoka Cancer Society and the Kaibara
Morikazu Medical Science Promotion Foundation.
2 To whom requests for reprints should be addressed, at Department of
Thoracic Surgery. Aichi Cancer Center Hospital. 1- I Kanokoden.
Chikusa-ku, Nagoya 464. Japan. Phone: 81 (52) 762-61 1 1: Fax: 81 (52)
764-2963.
INTRODUCTION
Loss of genetic material at a certain chromosomal locus
resulting in LOH3 is frequently seen in various types of human
malignancies, and it is considered as a hallmark of a tumor
suppressor gene (1, 2). In lung cancer, LOH is frequently
present at many chromosornal arms including 1p, 2q, 3p, Sq. 8p,
9p, 1 lp, l3q, l7p, and l8q (3-5). Among these abnormalities,
LOH at multiple loci on the short arm of chromosome 3 (3p) is
the most frequent genetic lesion in lung cancer, which was first
identified by Whang-Peng et a!. (6) by means of cytogenetics.
Of interest, it is the earliest appearing molecular abnormality
described to date in the pathogenesis of lung cancer (7, 8).
Subsequent numerous studies using RFLP revealed that (a)
allelic loss of 3p occurs in a significant fraction of NSCLC and
in almost all SCLC (4, 5, 9-15), and (b) there are at least three
distinct regions located at 3p25, 3p2l.3, and 3p14-cen corn-
monly deleted in lung cancer ( 14). However, corresponding
tumor suppressor genes have not been cloned.
Previous studies suggested that the 3p LOH is associated
with less differentiated histology or with the advanced stage in
adenocarcinoma of the lung ( 15) and with a trend toward a poor
prognosis (16). However, clinical implication or a prognostic
impact of the 3p LOH has not been established. In this study, as
a part of systematic search for molecular prognostic markers in
NSCLC (17-20), we examined 1 10 patients with NSCLC for 3p
LOH using PCR-based microsatellite polymorphism analysis.
We correlated the finding with various clinical features includ-
ing patient survival.
MATERIALS AND METHODS
Patients and DNA. During a 21-month period from July
1991 to April 1993, 143 consecutive patients underwent pulmo-
nary resection for treatment of NSCLC at the Department of
Surgery II, University of Occupational and Environmental
Health as a routine clinical practice. Of them, 1 10 patients
(77%) were studied. The criterion of the patients for inclusion in
this study was solely availability of paired normal lung tissue
and tumor materials. There were 61 adenocarcinornas, 38 squa-
mous cell carcinomas, 7 large cell carcinomas, and 4 other
types. Thirty-eight patients had stage I disease, 8 had stage II. 38
had stage lila, I5 had stage IlIb. and I 1 had stage IV disease.
For postoperative follow-up, patients were asked to visit our
clinic for examinations including chest X-ray and tumor marker
determination every month for the first year, every other month
for the second year, and then every 3 months for the third year
and so on. Computed tomographic scanning and bone scinti-
gram were performed at least once every year after the opera-
Research.
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