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Objective: To evaluate prognostic impact of maspin expression in patients with resected non-small cell lung cancer (NSCLC)., Study Design: From 1996 to 2001, 439 patients underwent radical surgery for NSCLC at the Polytechnic University of the Marche Region. Maspin expression was detected as cytoplasmic and nuclear staining of neoplastic cells. For cytoplasmic staining, cases were classified as negative, low positive, and high positive. In positive cases, intensity of staining was also considered and scored. A similar classification was used for nuclear staining, but intensity was not considered., Results: The analysis showed that smoking history, pathologic stage of disease, N status, histologic grading, sex, and Eastern Cooperative Oncology Group performance status had a prognostic impact on overall survival (OS). Expression of maspin was also found to be an independent prognostic factor. A statistically significant longer OS was seen in patients with higher compared with lower expression of nuclear maspin, and poorer OS was present in patients with a higher intensity of cytoplasmic staining. Nuclear expression of maspin was also found to be an independent prognostic factor at multivariate analysis., Conclusion: Results suggest that overexpression of maspin correlates with favorable prognosis in NSCLC. and may be a useful clinical marker.

Objective: To verify whether epidermal growth factor receptor (EGFR) status could be considered a prognostic factor and assessment of it an effective tool for planning therapy in patients with non-small cell lung cancer (NSCLC)., Study Design: From 1996 to 2001, 439 patients underwent radical surgery for NSCLC at the Polytechnic University of the Marche Region. EGFR expression was detected as membranous and/or cytoplasmic staining of neoplastic cells with various intensity and was considered positive when > or = 1% of the tumor cells had membranous staining., Results: Samples from 423 patients were available for EGFR analysis. EGFR expression and a stronger intensity of staining were associated with a trend for a worse prognosis in the analysis of all of the patients. The subgroup analysis showed no prognostic significance in stages I and II but a significantly longer survival in patients with advanced disease (stage III and particularly N2) overexpressing EGFR., Conclusion: The results of our study, showing a significantly longer survival in patients with advanced disease (stage III, particularly N2) overexpressing EGFR, present a new perspective, both for prognostic evaluation of patients with radically resected NSCLC and for the management of adjuvant treatment also employing targeted therapy.

Objective: To study how to identify patients with "triple negative" sporadic breast cancers (BCs) having BRCA1 silenced or down-regulated due to epigenetic BRCA1 inactivation., Study Design: We selected, from our database, patients diagnosed with BC between 1995 and 2001 with tumors exhibiting the "triple negative" phenotype. "Triple positive" tumors were used as controls. BRCA1 protein expression was determined by immunohistochemistry. Methylation specific polymerase chain reaction (PCR) and bisulfite sequencing on genomic DNA were used to assess BRCA1 promoter methylation. BRCA1 m-RNA expression analysis was conducted by real-time PCR., Results: Forty-four triple negative and 68 controls (triple positive) were eligible for our analysis. BRCA1 promoter methylation was present in 31.8% of triple negative and in 20.6% of triple positive cases. BRCA1 was inactivated (absent BRCA1 m-RNA expression and lack of BRCA1 protein) in 21.4% of tumors with BRCA1 promoter methylation, as compared with 6% of non-methylated ones (p = 0.0453)., Conclusion: BRCA1 inactivation due to promoter methylation could play an important role in some sporadic BC cases. Patients with this signature could represent the basis for prospective studies aiming to compare clinical response to different drugs.