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연세대학교 의과대학 Yonsei Medical Journal Yonsei Medical Journal 제60권 제10호
발행연도
2019.1
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898 - 904 (7page)

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Purpose: Sonic hedgehog (Shh) signaling pathway is known to play a crucial role in carcinogenesis in various malignancies, includinglung cancer regarding tumorigenesis, angiogenesis, and cellular differentiation. The aim of this study was to investigatethe value of components of Shh pathway as a prognostic marker in extensive stage small cell lung cancer (ES-SCLC) patients. Materials and Methods: We retrospectively analyzed data of 36 patients who were diagnosed with ES-SCLC between 2008 and2012 at a single center. We performed immuo-histochemistry for glioma-associated oncogene homolog zinc finger protein 1 (Gli1),patched, Shh, and Ptch-mediated repression of smoothened (Smo) proteins using formalin-fixed, paraffin-embedded tissue derivedfrom primary tumors. We then conducted survival analysis to evaluate the prognostic impact of these markers. Results: All 36 patients received platinum-based doublet chemotherapy. The median progression free survival and median overallsurvival were 6.9 months [95% confidence interval (CI), 6.5–7.3] and 11.7 months (95% CI, 9.1–14.3), respectively. The overall responserate was 84%. Of the 36 tissue specimens examined, over-expression of Gli1, Patched, Shh, and Smo was found in 12(33.3%), five (13.9%), five (13.9%), and six (16.7%) cases, respectively. We found that high expression of Shh was associated withworse progression free survival (6.3 vs. 7.6 months, p=0.005) and overall survival (9.2 vs. 12.0 months, p=0.039) by both univariateand multivariate analyses, whereas other markers were not related to patient prognosis. Conclusion: A high proportion of small cell lung cancer tumors express proteins related to Shh pathway, and over-expression ofShh is correlated with poor prognosis.

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