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2017 ; 13
(5
): 3695-3702
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Immunohistochemical analysis of NANOG expression and epithelial-mesenchymal
transition in pulmonary sarcomatoid carcinoma
#MMPMID28529586
Tamaki T
; Shimizu T
; Niki M
; Shimizu M
; Nishizawa T
; Nomura S
Oncol Lett
2017[May]; 13
(5
): 3695-3702
PMID28529586
show ga
Pulmonary sarcomatoid carcinomas (PSCs) are defined as a group of poorly
differentiated non-small cell lung cancers that demonstrate sarcoma-like
differentiation. The mechanism of mesenchymal differentiation in PSC is
epithelial-mesenchymal transition (EMT). The expression of homeobox protein NANOG
(NANOG), which regulates the pluripotency of embryonic stem cells, is associated
with the EMT process. Therefore, the present study aimed to assess the expression
level of NANOG and the status of the EMT process in PSC. The data of patients
with PSC were retrospectively reviewed and immunohistochemical analyses were
performed on patient samples to examine the expression of NANOG and
EMT-associated proteins. The comparator group included randomly selected patients
with matched clinicopathological characteristics who had pulmonary adenocarcinoma
(PA). In the present study, 12 patients with PSC (4 females and 8 males) were
enrolled; their median age was 65 years (range, 36-79 years), and the number of
patients with stage IB, IIB, IIIA, IIIB and IV disease were 1, 1, 1, 1 and 8,
respectively. The immunoreactive score (IRS) for E-cadherin was significantly
lower in the PSC group compared with the PA group (P<0.0001), whereas the IRS for
vimentin was significantly higher in the PSC group compared with the PA group
(P<0.0001). However, the IRS for NANOG was significantly decreased in the PSC
group compared with the PA group (P<0.0001), which suggests that NANOG does not
serve an essential role in EMT in PSC. In addition, the overall survival of
patients with PSC was significantly lower compared with that of patients with PA
(median survival time, 7.0 vs. 35.6 months, respectively; P=0.0256). However, no
significant difference was observed in the OS of patients who expressed low
compared with high levels of NANOG (P=0.4416). In conclusion, it was clearly
demonstrated that cytoplasmic NANOG expression was significantly lower in PSC
compared with PA, and that the EMT process in PSC was accelerated, compared with
that in PA.