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High Serum Concentrations of Sialyl Lewisx Predict Multilevel N2 Disease in Non–Small-Cell Lung Cancer

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Abstract

Background

The purpose of this study was to analyze the clinical significance of serum Sialyl Lewisx (SLX) concentrations as a predictor of N2 disease in patients with non–small-cell lung cancer.

Methods

The study included 272 patients with non–small-cell lung cancer who underwent pulmonary resection in our institution between January 1998 and December 2003. Of 272 patients, the serum concentrations of SLX were measured by using a commercially available radioimmunoassay kit.

Results

The 5-year survival rates of patients with concentrations of SLX > 38 U/mL and those with lower concentrations were 32% and 69%, respectively (P < .0001). The median serum concentration of SLX in patients with multilevel N2 or N3, single-level N2, and N0/1 disease were 44, 30, and 27 U/mL, respectively. The concentrations of serum SLX in patients with multilevel N2 disease were significantly higher than those in patients with single-level N2 or those with N0/1 disease (Mann-Whitney U-test; P < .0001). Although the sensitivity of SLX for identifying patients with non–small-cell lung cancer was only 24% in all patients, the sensitivity of SLX increased as the N-factor increased; the sensitivity of N0/1 disease was 15%, that of single-level N2 disease was 22%, and that of multilevel N2 or N3 disease was 71%.

Conclusions

High serum concentrations of SLX predicted multilevel N2 disease and the associated poor outcome. Although the sensitivity of serum SLX is not acceptable for use as a screening tumor marker, we suggest that the serum concentration of SLX is useful as a staging marker to determine the strategy of treatment.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Osaka City University Medical School, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan

    Shinjiro Mizuguchi MD, Kiyotoshi Inoue MD, Takashi Iwata MD, Tatsuya Nishida MD, Nobuhiro Izumi MD, Takuma Tsukioka MD & Noritoshi Nishiyama MD

  2. Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan

    Shinjiro Mizuguchi MD, Takuma Tsukioka MD & Shigefumi Suehiro MD

  3. Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan

    Takahiro Uenishi MD

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  1. Shinjiro Mizuguchi MD
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  2. Kiyotoshi Inoue MD
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Correspondence to Shinjiro Mizuguchi MD.

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Mizuguchi, S., Inoue, K., Iwata, T. et al. High Serum Concentrations of Sialyl Lewisx Predict Multilevel N2 Disease in Non–Small-Cell Lung Cancer. Ann Surg Oncol 13, 1010–1018 (2006). https://doi.org/10.1245/ASO.2006.05.018

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  • DOI: https://doi.org/10.1245/ASO.2006.05.018

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