Telomerase activity and serum levels of p53 protein as prognostic factors of survival in patients with advanced non-small cell lung cancer

Purpose: Evaluation of relationships between survival time of patients with advanced, non-resectable non-small cell lung cancer (NSCLC) and telomerase activity in aspirates, collected from primary lung tumours, and serum p53 protein levels. Material and methods: The study group consisted of 52 patients with advanced (stage IIIB and IV) non-small cell lung cancer. In all of them, transthoracic fine-needle biopsy (TFNB) of focal pulmonary lesion was performed. The aspirates were subjected to telomerase activity by the PCR-ELISA PLUS method and serum levels of p53 protein were determined by the ELISA method. Additionally, clinical advancement of cancer and the time period of survival were assessed in the studied group. Kaplan-Meyer method and Cox analysis were used for statistical evaluation of survival prognosis. Results: Increased telomerase activity was observed in 42 (81%) of the patients with non-resectable non-small cell lung cancer. Elevated concentrations of serum p53 protein were found in 28 (54%) of the participants. The following death rates were noted during the entire study period: twenty-three (23) (62%), out of 37 patients with increased telomerase activity, 7 (47%), out of 15 without detectable telomerase activity in primary lung tumour, 16 (57%), out of 28 subjects with increased serum levels of p53 protein and 14 (58%), out of 24 with no increased serum levels of p53. A significant relationship was observed in Cox hazard analysis between the time of survival and telomerase activity, while no such relationship was observed between the survival time period and serum p53 protein levels or sex, age, primary lung tumour size, lymph node status or development of distant metastases. Conclusion: Telomerase activity in advanced primary non-small cell lung cancer is a better predictor of patients' survival than serum levels of p53 protein. The assessment of telomerase activity supplements in the prognosis of survival in the course of non-resectable NSCLC. (C) 2010 Elsevier Ltd. All rights reserved.