Serological investigation of the clinical significance of fascin in non-small-cell lung cancer

Objectives: Fascin, a conserved actin bundling protein family member, is frequently up-regulated in various cancer types, including non-small-cell lung cancer (NSCLC), and it plays increasingly important roles in the progression of tumor invasion and metastasis. However, variations in the serum fascin level in tumor patients are usually neglected. Materials and Methods: In the present study, serum samples from 501 stage I-IV NSCLC patients and 109 healthy volunteers were investigated by an enzyme-linked immunosorbent assay. Results: The serum fascin level was markedly increased in the NSCLC patients (P < 0.05), particularly in advanced cases (P < 0.01), compared with that in the healthy controls. We also found that the serum fascin level was significantly correlated with female sex (P = 0.02), non-smoking status (P = 0.044), and adenocarcinoma histology (P < 0.001), with a higher positive rate relative to each counterpart. Furthermore, our results suggested that the serum fascin level reflects the aggressive progress of both lymphatic (P < 0.001) and distant (P < 0.001) metastases in NSCLC. A survival analysis of 283 eligible patients who underwent a follow-up examination after 3 years revealed that the patients in the serum fascin-positive group had a significantly lower overall survival rate compared with those in the negative group for 134 non-distant metastatic (stage M0) cases (P = 0.044). A subsequent Cox regression analysis revealed that the serum fascin level was an independent prognostic factor for M0-stage NSCLC (univariate, P = 0.001; multivariate, P = 0.038). Conclusion: Our study suggests that the serum fascin level is an effective indicator of tumor aggressiveness, and that it plays an important role in the prognosis of NSCLC, particularly for non-distant metastatic patients. (C) 2013 Elsevier Ireland Ltd. All rights reserved.