Expression of periostin in patients with non-small cell lung cancer: correlation with angiogenesis and lymphangiogenesis

Abstract

The aim of this study was to evaluate periostin expression measured immunohistochemically in patients with non-small cell lung cancer (NSCLC) and to determine its association with clinical features, prognosis, angiogenesis, and lymphangiogenesis. We investigated periostin expression in a series of 88 patients with NSCLC. We also determined whether expression of periostin correlated with microvessel density and lymphatic microvessel density. Periostin was expressed in 42% of 88 patients. Its expression was significantly correlated with tumor size, lymph node metastasis, disease stage, and lymphatic invasion (p=0.0128, 0.0015, 0.0310 and 0.0273, respectively). There also was a significant relation between periostin expression and microvessel density and lymphatic microvessel density (all p<0.0001). Five-year survival rates were better in patients with negative periostin expression than in those with positive periostin expression (p=0.0044). Periostin expression was not significant in a multivariate additive model. Our findings show that periostin correlates with increased tumor progression and a worse prognosis in NSCLC, as well as with angiogenesis and lymphangiogenesis.

The role of periostin in neoplastic processes

“…These results strongly suggest that POSTN secreted by tumor cells may act in a paracrine manner to induce tumor angiogenesis during metastatic growth [29]. Similarly, in non-small-cell lung cancer (NSCLC), Takanami et al [49] showed a correlation between the presence of POSTN and the microvessel density, assessed on the basis of the expression of the antigen F8RA (Factor 8 Related Antigen/von Willebrand Factor).…”

“…It was reported that lymphangiogenesis could be promoted by POSTN itself and by the POSTN--induced upregulation of VEGF-C [52]. Similarly, Takanami et al [49] demonstrated in non-small-cell lung cancer a significant relationship between the presence of POSTN and the lymphatic vessel density (LMVD); the lymph vessels were labeled with podoplanin (D2-40), a glycoprotein produced by the vascular endothelium of lymph vessels. POSTN may be an important factor in the initiation and stimulation of both the angiogenesis and lymphangiogenesis in tumors, but further studies are needed to thoroughly elucidate these mechanisms.…”

“…These observations indicate that a high concentration of POSTN in the serum may be a negative prognostic factor for NSCLC. Takanami et al [49] found significant correlation between POSTN expression determined by immunohistochemistry and tumor size, lymph node metastasis, disease stage, and lymphatic invasion. A significant positive correlation was also found between POSTN expression and microvessel density and density of lymphatic microvessels (LMVD).…”

“…Increased expression of POSTN has been observed in various tumor types, including breast [44,48,[56][57][58], NSCLC [27,49,[59][60][61][62], colorectal [19,29,63], stomach cancers [64][65][66][67][68], pancreatic [32,69], prostate [70][71][72][73][74][75], ovarian cancer [76][77][78][79], and glioblastomas [80][81][82] (Table 1).…”

“…As with other cancers of epithelial origin, non-small--cell lung cancer (NSCLC) was examined for POSTN expression [27,49,59,61,62].…”