1. ¹Department of Pathology, University Health Network—Princess Margaret Hospital and Ontario Cancer Institute, Toronto, ON, Canada
2. ²Division of Applied Molecular Oncology, University Health Network—Princess Margaret Hospital and Ontario Cancer Institute, Toronto, ON, Canada
3. ³Department of Biostatistics, University Health Network—Princess Margaret Hospital and Ontario Cancer Institute, Toronto, ON, Canada
4. ⁴Faculty of Medicine, Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
5. ⁵Department of Laboratory Medicine, St Michael's Hospital, Li-Ka Shing Knowledge Institute, Toronto, ON, Canada

Correspondence: Dr S Jothy, MD, PhD, Department of Laboratory Medicine, St Michael's Hospital, Li-Ka Shing Knowledge Institute, 30 Bond Street, Toronto, ON, Canada M5B 1W8. E-mail: Jothys@smh.toronto.on.ca

Received 9 August 2007; Revised 23 January 2008; Accepted 24 January 2008; Published online 9 May 2008.

Abstract

Glypican-3 is a membrane-bound proteoglycan whose expression has been linked to malignancies through the existence of both mutations and aberrant protein expression. Reports on glypican-3 expression in lung cancer were limited, with some evidence for loss of expression, which suggested a tumor-suppressor role. We sought to evaluate glypican-3 expression in lung cancer at the protein and mRNA levels and correlate it with clinical, histological and genomic characteristics such as RAS mutation status. We used immunohistochemistry on tissue microarray to study glypican-3 expression in 97 patients, evaluated glypican-3 mRNA levels by quantitative polymerase chain reaction in 143 patients and identified RAS mutations by allele-specific oligonucleotide hybridization. We correlated the results with clinical and histological data. Glypican-3 immunostaining was negative in all normal lung tissues, but positive in 23% of lung carcinoma samples. High protein and mRNA expression was associated with squamous histology (positive stain in 55% of squamous cell carcinoma vs 8% of adenocarcinoma, P<0.0001 for both immunostaining and mRNA). RAS mutations were highly associated with adenocarcinoma and low glypican-3 mRNA expression (P<0.0001 for both). Among smokers, glypican-3 mRNA expression was reduced in adenocarcinoma patients (P=0.013), and was elevated in those with squamous cell carcinoma (P=0.03, interaction P=0.0009). These opposing associations also correlated with the smoking burden. Patients with tumors staining positively for glypican-3 smoked significantly more than patients with tumors staining negatively (P=0.013). No association was found between glypican-3 expression and patient outcome. In conclusion, glypican-3 was overexpressed in cancerous compared with normal lung tissue. Adenocarcinoma and squamous cell carcinoma had differential expression of glypican-3, with predilection to squamous cell carcinoma patients who smoked. Glypican-3 expression in squamous cell carcinoma as an oncofetal protein renders it a potential candidate marker for early detection of lung squamous cell carcinoma.