[Genetic alteration of lung cancer as a prognostic marker and its therapeutic implications]

Many genetic lesions found in non-small cell lung cancer (NSCLC) have been reported to be associated with a poor prognostic outcome of this disease. Such alterations include mutations of ras genes, overexpression of myc or erbB2 genes and inactivation of RB genes. Among them, the prognostic implications of the p53 gene have been most extensively studied; over 20 reports have been published. However, the significance of the p53 gene abnormality also still remains unclear. Therefore, we re-evaluated our 562 patients with NSCLC retrospectively to see if the p53 gene abnormality really had an effect on patients' survival in this large cohort. There was no effect of p53 gene abnormality on all patients with NSCLC or on those with squamous cell carcinoma, but p53 abnormality was a significant, independent prognostic marker in adenocarcinoma subset. We should plan a clinical trial of postoperative adjuvant therapy for patient with pulmonary adenocarcinoma incorporating information on the p53 gene status to possibly translate these findings into clinical practice.