Dysregulation of circulating CDC42 and its correlation with demographic characteristics, comorbidities, tumor features, chemotherapeutic regimen and survival profile in non-small-cell lung cancer patients

Objective Cell division control protein 42 (CDC42) induces the immune escape, represses the CD8(+) T-cell activation, and further leads to the tumor metastasis in various neoplasms, whereas the correlation of circulating CDC42 with clinical features and prognosis of non-small-cell lung cancer (NSCLC) remains elusive. Hence, the current study aimed to investigate this topic. Methods Peripheral blood mononuclear cells from 263 NSCLC patients before treatment and 50 health controls (HC) were used for CDC42 determination by reverse transcription quantitative polymerase chain reaction (RT-qPCR) assay. Results CDC42 expression was higher in NSCLC patients than HCs (p < 0.001). Besides, elevated CDC42 expression was correlated with the occurrence of lymph node (LYN) metastasis (p = 0.003) and advanced TNM stage (p = 0.007), but not related to other tumor features, demographic characteristics, comorbidities, nor neoadjuvant/adjuvant chemotherapy (all p > 0.05). Additionally, elevated CDC42 expression was correlated with unfavorable accumulating disease-free survival (DFS) (p < 0.001) and overall survival (OS) (p = 0.025). More importantly, multivariate Cox's proportional hazard regression analysis revealed that elevated CDC42 expression (hazard ratio (HR): 1.284, p < 0.001) and higher TNM stage (HR: 1.428, p = 0.003) were independently associated with shorter DFS, meanwhile elevated CDC42 expression (HR: 1.193, p = 0.035), higher pathological grade (HR: 1.558, p = 0.003), higher TNM stage (HR: 1.703, p = 0.001) and higher Eastern Cooperative Oncology Group performance status (ECOG PS) score (HR: 1.538, p = 0.038) were independently correlated with unsatisfying OS. Conclusion Circulating CDC42 is highly expressed with its overexpression linked with LYN metastasis, poor DFS, and OS in NSCLC patients.

Automated summary

This study revealed that elevated circulating CDC42 expression in NSCLC patients is associated with lymph node metastasis, poor DFS, and OS. Additionally, higher TNM stage was also independently correlated with shorter DFS and unsatisfying OS.