Prognostic Value of Synaptophysin and Chromogranin A Expression in Patients Receiving Palliative Chemotherapy for Advanced Non-Small-Cell Lung Cancer

Abstract

Background: Chemotherapy is the principal treatment method for patients with advanced non-small-cell lung cancer (NSCLC). Treatment with platinum-based and novel chemotherapeutic regimens, compared to monotherapy, slightly increases the response rates to 20-40%. The predictive and prognostic values of molecular factors are highly variable; however, data on clinical-demographic factors are still burdened by significant limitations. Objectives: The aim of this study was to assess the prognostic value of synaptophysin and chromogranin A protein expression in patients receiving palliative chemotherapy for advanced NSCLC. Methods: The study population consisted of 23 women and 116 men. The median age was 57.3 years. Expression of synaptophysin and chromogranin was assessed using a two-step model of immunohistochemical staining. Level 0 represented lack of activity, while level 1 represented its expression. Results: Expression of synaptophysin and chromogranin A was observed in 12 (8.6%) and 5 (3.6%) patients, respectively. The risk of death was significantly lower in patients with expression of synaptophysin (p = 0.008) and chromogranin A (p = 0.014). The 12- and 24-month survival rate of patients with synaptophysin expression was 64% (95% CI 0.35-0.93), while for patients without expression it was 46% (95% CI 0.36-0.56) and 16% (95% CI 0.07-0.25), respectively. The 12- and 24-month survival rate of patients with chromogranin expression was 80% (95% CI 0.44-1.00), while for chromogranin A-negative patients it was 47% (95% CI 0.37-0.57) and 19% (95% CI 0.10-0.28), respectively. We did not observe associations between expression of synaptophysin and chromogranin A and the other typical prognostic factors. Conclusions: Expression of synaptophysin and chromogranin A was associated with a longer median overall survival and might have prognostic value. These results should be confirmed in a prospective study.

Prognostic value of immunohistochemical factors in esophageal small cell carcinoma (ESCC): analysis of clinicopathologic features of 73 patients

“…Moreover, the level of IHC markers expression may vary in different histological typing. For instance, expression of Syn was more frequently observed in patients with adenocarcinoma than those with squamous cell carcinoma (12,24). TTF-1 is commonly expressed in poorly differentiated NECs regardless of the site of origin (25,26).…”

“…Dariusz M.'s study showed that the 12-and 24-month survival rate of patients with Syn expression was 64% in non-small-cell lung cancer, while for patients without expression it was 46% and 16%, respectively. The 12-and 24-month survival rate of patients with CgA expression was 80%, while for CgAnegative patients it was 47% and 19%, respectively (24). Tan D's study showed patients with expression of TTF-1 had a median survival of greater than 57.3 months, while the survival time was only 39.4 months for patients with TTF-1-negative tumors (P=0.006) (35).…”

“…In a study enrolled 125 Chinese patients with ESCC showed patients with higher CgA protein expression had a superior long survival than those without CgA expression (P=0.037) (33). Studies about other types of tumor concluded that the percentage of tumor cells with the ability to produce neuroendocrine markers was a significant independent prognostic factor associated with favorable outcomes (24,34,35). Dariusz M.'s study showed that the 12-and 24-month survival rate of patients with Syn expression was 64% in non-small-cell lung cancer, while for patients without expression it was 46% and 16%, respectively.…”

Evaluation of DLL3 Expression in Small Cell Lung Carcinoma in Southern Brazil and its Correlation with EGFR, PDL-1, CICLIN D 1, Neuroendocrine Markers and Clinical Findings

“…However, around the 15th month, mortality in both groups is the same. In groups of positive DLL3 patients with negative chromogranin, the survival rate by the Kaplan-Meier test was slightly higher (p 0.299) [28,29].…”

“…Our data on the expression of chromogranin A corroborate with the studies by Kowalki et al The authors report that chromogranin and synaptophysin are associated with SCLC survival and that they act as an indirect predictive factor. Neoplasms with high rates of chromogranin contain a greater amount of secretory vesicles in neuroendocrine cells, conferring a strong potential for malignant transformation [28,29].…”