Rhesus CE expression is an independent prognostic factor in non-small cell lung cancer

Abstract

<b>Introduction:</b> The influence of blood group antigens on cancerogenesis is shown for distinct tumor types (<i>e.g.</i> gastric cancer). For lung cancer, however, the impact of Rhesus blood group factors is unknown. <b>Methods:</b> To investigate the impact of Rhesus blood groups on the course of NSCLC, a study collective from two academic medical centers was analyzed (n=516; mean age 62±10 yrs; 28% female; stage I/II 37%, stage III 27%, stage IV 36%; squamous cell carcinoma n=195 [38%], adeno carcinoma n=238 [46%], others n=83 [16%]). The variability of RhCE phenotypes was categorized into 9··ee9 (<i>i.e.</i> ccee, Ccee, CCee), 9ccE·9 (<i>i.e.</i> ccEe, ccEE) and 9C·E·9 (<i>i.e.</i> CcEe, CCEe, CcEE, CCEE). <b>Results:</b> In pulmonary adenocarcinoma patients with Rh 9··ee9 revealed improved overall survival (n=181, median 29 months, HR 1.00 [index]) compared to patients with Rh 9ccE·9 (n=29, median 19 m., HR 1.76 [1.15-2.70]), and Rh 9C·E·9 (n=28, median 10 m., HR 2.65 [1.70-4.12]). Differences were clinically meaningful both in univariate model (Log Rank p&lt;.001) and multivariate model (Cox propoprional hazard model p&lt;.001), respectively. Furthermore, Rh 9··ee9 was associated with reduced incidence of CNS-metastasis in stage IV adenocarcinoma (Kruskal-Wallis p=.011) and metastasis count (oneway-ANOVA p=.018). <b>Conclusion:</b> To the best of our knowledge, data demonstate for the first time an association of Rhesus blood groups and lung cancer course. Phenotypic RhCE expression in NSCLC is an independent prognostic factor for overall survival in pulmonary adenocarcinoma. Besides, metastatic spread in stage IV pulmonary adenocarcinoma shows RhCE dependent influence in total metastasis count and CNS-metastasis occurrence rate.