Küçük Hücreli Dışı Akciğer Kanserinin Tanı, Tedavi Yanıtı ve Prognoz Tayininde SULF2 Ekspresyonunun Değerlendirilmesi

Abstract

Lung cancer is the most frequently diagnosed cancer and the leading cause of cancer-related death worldwide. The NSCLC subgroup accounts for approximately 85% of all lung cancers. Subhistological typing of NSCLC is extremely important because it changes the treatment approach. More than 60% of patients with lung cancer are diagnosed at the local advanced or advanced stage. Diagnostic and prognostic biomarkers are needed in lung cancer. SULF2 plays a role in the regulation of cell signaling by separating the 6-O-S group in the heparan sulfate chain and has been shown to be a poor prognostic marker in many tumors. This study is aimed to evaluate the diagnostic value of SULF2 in NSCLC (its usefulness in distinguishing between adenocarcinoma and squamous cell carcinoma) and its prognostic effect by investigating immunohistochemically SULF2 expression in the tumor tissues of the patients who underwent primary tumor surgery or metastasectomy for NSCLC between January 2009 and December 2016. Of the 104 NSCLC tumor tissues 56,7% were adenocarcinoma and 43,7% were squamous cell carcinoma histology. When the extensity and severity of SULF2 expression were examined separately, there was no significant difference between squamous cell carcinoma and adenocarcinoma. Although not statistically significant, over 50% of SULF2 expression was found to be higher in adenocancer patients than in patients with squamous cell carcinoma (60% vs. 40%, p=0,18). When SULF2 expression level was evaluated according to tumor stages, more extensive staining in early stage tumors was statistically significant (p=0,039). No statistically significant relationship was found between age at diagnosis, smoking status, ECOG performance status, CEA level, presence of metastasis at diagnosis, progression of follow-up, follow-up metastasis frequency and SULF2 expression. When SULF2 expression level was examined in terms of progression-free survival and overall survival, no statistically significant difference in survival was observed. İt is notable that progression-free survival curves are worse in the group with higher SULF2 expression, although it does not reach statistical significance. In conclusion, it is thought that SULF2 expression is not a useful marker for distinguishing histologic subtypes of NSCLC but may be used as a prognostic marker.