• Arch Med Sci · Jul 2019

    Klotho expression and nodal involvement as predictive factors for large cell lung carcinoma.

    • Barbara Brominska, Piotr Gabryel, Donata Jarmołowska-Jurczyszyn, Małgorzata Janicka-Jedyńska, Andrzej Kluk, Maciej Trojanowski, Beata Brajer-Luftmann, Kosma Woliński, Rafał Czepczyński, Paweł Gut, Gabriel Bromiński, Przemysław Majewski, Wojciech Dyszkiewicz, and Marek Ruchała.
    • Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland.
    • Arch Med Sci. 2019 Jul 1; 15 (4): 1010-1016.

    IntroductionKlotho has been recently described as a carcinogenesis suppressor. Large cell neuroendocrine lung carcinoma (LCNEC) is a rare, highly malignant neoplasm. In the light of increasing incidence of neuroendocrine tumours, biomarkers predicting survival are needed. We consider that Klotho might be one.Material And MethodsWe analysed records of all patients diagnosed with LCNEC, atypical carcinoid and typical carcinoid operated on in our institution between 2007 and 2015. Initially, we found 134 cases. Forty-six specimens were unattainable and thus excluded from research. All patients diagnosed with LCNEC according to the WHO classification were included in the study. Immunohistochemical staining for Klotho was performed. We retrospectively reviewed patient charts and analysed multiple variables.ResultsPositive staining for Klotho was present in 36 tissue specimens, while 12 patients were Klotho-negative. Survival length was significantly higher in Klotho-positive cases (p = 0.024), while advanced nodal status (N1 and N2) represented a marker of poor outcome (p = 0.011). In multivariate analysis, both Klotho presence (p = 0.015; HR = 0.37; 95% CI: 0.17-0.86) and nodal involvement (p = 0.007; HR = 3.04; 95% CI: 1.37-6.82) were independent prognostic factors. Tumour vessel invasion and visceral pleura infiltration were not associated with worse treatment results. Klotho presence predicted a favourable prognosis in these groups (p = 0.018; p = 0.007).ConclusionsOur results suggest that Klotho might be a positive factor for predicting survival in LCNEC and nodal involvement a negative one. Thus, these two markers may assist in the selection of subjects with unfavourable prognosis and to personalise therapy regimens.

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