This study aims to investigate the expression level of pro-opiomelanocortin (POMC) and its prognostic value in non-small cell lung cancer (NSCLC). Immunohistochemical staining was used to detect the expression level of POMC. Correlations between POMC expression and clinical and pathological characteristics were evaluated with the chi-square test, and the prognostic value was determined with the Kaplan–Meier method and COX proportional hazards model, α < 0.05. Of the samples, 48.0 % had positive POMC expression. POMC expression was significantly related to poorly differentiated tumors, N-stage, p-stage, postoperative failure pattern, expression of vimentin, and expression of E-cadherin (P < 0.05). Multivariate analysis revealed that POMC-positive expression was an independent risk factor for disease-free survival (hazard ratio (HR) 1.988, 95 % confidence interval (CI) 1.094–3.910, P = 0.024) and overall survival (HR 1.892, 95 % CI 1.726–3.709, P = 0.036). The addition of POMC protein expression to the prognostic model using pathological stage markedly improved the prognostic potential, and the area under the ROC increased from 0.691 to 0.775. Further study revealed that patients with POMC-negative expression can benefit more from a regimen of paclitaxel and carboplatin chemotherapy than a regimen of vinorelbine and carboplatin compared to patients with POMC-positive expression. We found that POMC-positive expression is a novel, independent poor prognostic marker in patients with NSCLC. Prospective studies are needed to validate the potential prognostic value of POMC in combination with the current staging system and in consideration of adjuvant chemotherapy.
Pro-opiomelanocortin (POMC) Non-small cell lung cancer (NSCLC) Prognosis
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This work was supported by the Tianjin Municipal Science and Technology Commission (12ZCDZSY15400, 12JCYBJC17800), National Natural Science Foundation of China (81302001 and 81470137), and China Postdoctoral Science Foundation (2014M550147).
LG H and XL Z performed the experiment and wrote the manuscript. B Z and CG L were responsible for the experimental design, collection of the tumor samples, and experiment data analysis. CL W was the guarantor of all the work and responsible for editing the manuscript.
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