Research article

Prognostic significance of MCM2, Ki-67 and gelsolin in non-small cell lung cancer

Jun Yang¹ , Nithya Ramnath¹ , Kirsten B Moysich¹ , Harold L Asch¹ , Helen Swede² , Sadir J Alrawi¹ , Joel Huberman¹ , Joseph Geradts³ , John SJ Brooks⁴ and Dongfeng Tan⁵

¹Roswell Park Cancer Institute, Buffalo, NY 14263, USA

²Connecticut Tumor Registry, Department of Public Health, Hartford, CT 06134, USA

³Department of Pathology, Duke University, Durham, NC 27710, USA

⁴Dept. of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA

⁵Dept. of Pathology and Lab Medicine, University of Texas Health Science Center, Houston, TX 77030, USA

author email corresponding author email

BMC Cancer 2006, 6:203doi:10.1186/1471-2407-6-203

Published:	1 August 2006

Abstract

Background

Uncontrolled proliferation and increased motility are hallmarks of neoplastic cells, therefore markers of proliferation and motility may be valuable in assessing tumor progression and prognosis. MCM2 is a member of the minichromosome maintenance (MCM) protein family. It plays critical roles in the initiation of DNA replication and in replication fork movement, and is intimately related to cell proliferation. Ki-67 is a proliferation antigen that is expressed during all but G₀ phases of the cell cycle. Gelsolin is an actin-binding protein that regulates the integrity of the actin cytoskeletal structure and facilitates cell motility. In this study, we assessed the prognostic significance of MCM2 and Ki-67, two markers of proliferation, and gelsolin, a marker of motility, in non-small cell lung cancer (NSCLC).

Methods

128 patients with pathologically confirmed, resectable NSCLC (stage I-IIIA) were included. Immunohistochemistry was utilized to measure the expressions of these markers in formalin-fixed, paraffin-embedded tumor tissues. Staining and scoring of MCM2, Ki-67 and gelsolin was independently performed. Analyses were performed to evaluate the prognostic significance of single expression of each marker, as well as the prognostic significance of composite expressions of MCM2 and gelsolin. Cox regression and Kaplan-Meier survival analysis were used for statistical analysis.

Results

Of the three markers, higher levels of gelsolin were significantly associated with an increased risk of death (adjusted RR = 1.89, 95% CI = 1.17–3.05, p = 0.01), and higher levels of MCM2 were associated with a non-significant increased risk of death (adjusted RR = 1.36, 95% CI = 0.84–2.20, p = 0.22). Combined, adjusted analyses revealed a significantly poor prognostic effect for higher expression of MCM2 and gelsolin compared to low expression of both biomarkers (RR = 2.32, 95% CI = 1.21–4.45, p = 0.01). Ki-67 did not display apparent prognostic effect in this study sample.

Conclusion

The results suggest that higher tumor proliferation and motility may be important in the prognosis of NSCLC, and composite application of biomarkers might be of greater value than single marker application in assessing tumor prognosis.