A three gene-based risk score predicts prognosis of resected non-small-cell lung cancer

Background: To study the prognosis-predicting value of a risk score based on phosphorylated At (p-Akt), vascular endothelial growth factor (VEGF), and Nin one binding (NOB1) expression in patients with resected non-small-cell lung cancer (NSCLC). Methods: A prospective cohort among 98 consecutive patients with resected NSCLC was conducted in 2009 to 2010. Immunohistochemistry was used in the detection of p-Akt, VEGF, and NOB1 expression. Any of three genes with positive expression was allocated a score of 1, otherwise scored 0. The risk score ranged from 0-3. Prognosis outcomes included overall survival (OS) and progression-free survival (PFS). Log-rank test and Cox hazard model were used to investigate the prognosis predicting value for the risk score. Results: In the 98 NSCLC tissue specimens, p-Akt, VEGF and NOB1 positive Expression rates were 42.9%, 66.3%, and 60.2%, respectively. The median for OS was 44 month, with 95% CI 35-51 months, and the median for PFS was 36 months, with 95% CI 25-49 months. Log-rank test showed OS and PFS related with TMN stage, lymph node metastasis, p-Akt expression, VEGF expression, NOB1 expression, and gene-based risk score (P<0.05). Multivariate COX analysis showed pTMN stage, lymph node metastasis, p-Akt expression, VEGF expression, and gene-based risk score were independent prognosis factors for OS and PFS. The adjusted HR for gene-based risk score with every one score increase was 1.21 [1.04-1.56] for OS and 1.19 [1.02-1.79] for PFS. Conclusions: Our results suggest the risk scores based on p-Akt, VEGF, NOB1 expression can predict postoperative survival in patients with resected NSCLC.