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. 2018 Jul;16(1):1123-1132.
doi: 10.3892/ol.2018.8763. Epub 2018 May 22.

Prognostic role of multidrug resistance-associated protein 1 expression and platelet count in operable non-small cell lung cancer

Linming Fang  1 , Huaying Sheng  1 , Danying Wan  1 , Chihong Zhu  1 , Ruibin Jiang  1 , Xiaojiang Sun  1   2 , Jianguo Feng  1   2
Affiliations

Prognostic role of multidrug resistance-associated protein 1 expression and platelet count in operable non-small cell lung cancer

Linming Fang et al. Oncol Lett. 2018 Jul.

Abstract

The overall survival rate of patients with non-small cell lung cancer (NSCLC) following resection remains poor due to the high rates of recurrence and metastasis. The investigation of novel biomarkers is clinically necessary to improve treatment strategies. Multidrug resistance-associated protein 1 (MRP1) and platelet count are linked to a poor prognosis in various types of cancer. However, it is unknown whether MRP1 or platelet count is a suitable prognostic indicator of NSCLC. In the present study, 427 patients with operable NSCLC were enlisted. The association of MRP1 expression and platelet count with clinical pathological factors and patient outcome was evaluated. MRP1 expression was found to be significantly associated with sex, histological type and tumor differentiation, while platelet count was significantly associated with smoking behavior, histological type and clinical stage. Platelet count was significantly higher in patients with negative MRP1 expression than in those with positive MRP1 expression. Survival analysis indicated that there was no association between MRP1 expression and disease-free survival (DFS) or overall survival (OS) time. In the patients with no lymph node metastasis, the OS time was significantly longer in patients with positive MRP1 expression than in those with negative expression. However, in the patients with lymph node metastasis, the DFS time was significantly shorter in patients with positive MRP1 expression than in those with negative expression. There was an association between the platelet count and DFS and OS times, which were significantly longer in patients with a normal platelet count than in those with thrombocytosis. In conclusion, MRP1 expression and platelet count are valuable independent prognostic biomarkers for survival in operable NSCLC.

Keywords: multidrug resistance-associated protein 1; non-small cell lung cancer; platelet; survival.

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Figures

Figure 1.
Figure 1.
Expression of MRP1 protein was localized in the cytoplasm (top panels: magnification, ×200; scale bars, 100 µm; bottom panels: magnification, ×400; scale bars, 50 µm). IHC, immunohistochemistry; MRP1, multidrug resistance-associated protein 1.
Figure 2.
Figure 2.
Platelet count was significantly higher in patients with negative MRP1 expression than in those with positive MRP1 expression (P=0.014). PLT, platelet; MRP1, multidrug resistance-associated protein 1.
Figure 3.
Figure 3.
Kaplan-Meier OS and PFS curves according to MRP1 expression. (A) There was no association between MRP1 expression and OS (P=0.441). (B) In the patients with no lymph node metastasis, the OS was significantly longer in patients with positive MRP1 expression compared with those with negative expression (P=0.009). (C) In the patients with lymph node metastasis, there was no association between MRP1 expression and OS. (D) There was no association between MRP1 expression and DFS (P=0.656). (E) In the patients with no lymph node metastasis, there was no association between MRP1 expression and DFS. (F) In the patients with lymph node metastasis, the DFS was significantly shorter in patients with positive MRP1 expression than in those with negative expression (P=0.022). MRP1, multidrug resistance-associated protein 1; OS, overall survival; DFS, disease-free survival.
Figure 4.
Figure 4.
Kaplan-Meier DFS and OS curves according to platelet count. (A) The OS was significantly longer in patients with a normal platelet count (<300×109/l) compared with in those with thrombocytosis (>300×109/l) (P=0.008). (B) There was no association between the platelet count and OS in the patients with no lymph node metastasis. (C) There was no association between the platelet count and OS in the lymph node metastasis patients. (D) The DFS was significantly longer in patients with a normal platelet count (<300×109/l) compared with in those with thrombocytosis (>300×109/l) (P=0.025). (E) There was no association between the platelet count and PFS in the patients with no lymph node metastasis. (F) There was no association between the platelet count and PFS in the lymph node metastasis patients. OS, overall survival; DFS, disease-free survival.
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