Curcumin Inhibits Non-Small Cell Lung Cancer Cells Metastasis through the Adiponectin/NF-κb/MMPs Signaling Pathway.

Adipose tissue is now considered as an endocrine organ involved in metabolic and inflammatory reactions. Adiponectin, a 244-amino acid peptide hormone, is associated with insulin resistance and carcinogenesis. Curcumin (diferuloylmethane) is the principal curcuminoid of the popular Indian spice, turmeric. Curcumin possesses antitumor effects, including the inhibition of neovascularization and regulation of cell cycle and apoptosis. However, the effects of adiponectin and curcumin on non-small cell lung cancer (NSCLC) remain unclear. In this study, we evaluated the expression of adiponectin in paired tumors and normal lung tissues from 77 patients with NSCLC using real-time polymerase chain reaction, western blotting, and immunohistochemistry. Kaplan-Meier survival analysis showed that patients with low adiponectin expression ratio (<1) had significantly longer survival time than those with high expression ratio (>1) (p = 0.015). Curcumin inhibited the migratory and invasive ability of A549 cells via the inhibition of adiponectin expression by blocking the adiponectin receptor 1. Curcumin treatment also inhibited the in vivo tumor growth of A549 cells and adiponectin expression. These results suggest that adiponectin can be a prognostic indicator of NSCLC. The effect of curcumin in decreasing the migratory and invasive ability of A549 cells by inhibiting adiponectin expression is probably mediated through NF-κB/MMP pathways. Curcumin could be an important potential adjuvant therapeutic agent for lung cancer in the future.

Ginkgo biloba extract decreases non-small cell lung cancer cell migration by downregulating metastasis-associated factor heat-shock protein 27.

Heat-shock proteins (HSPs) are molecular chaperones that protect proteins from damage. HSP27 expression is associated with cancer transformation and invasion. Ginkgo biloba extract (EGb761), the most widely sold herbal supplement, has antiangiogenic effects and induces tumor apoptosis. Data regarding the effect of EGb761 on HSP expression is limited, particularly in cancer. HSP27 expression in paired tumors and normal lung tissues of 64 patients with non-small cell lung cancer (NSCLC) were detected by real-time PCR, western blotting, and immunohistochemistry. NSCLC cell lines (A549/H441) were used to examine the migratory abilities in vitro. NSCLC tissue showed higher HSP27 expression than normal lung tissue. Kaplan-Meier survival analysis showed that NSCLC patients with low HSP27 expression ratio (<1) had significantly longer survival time than those with a high expression ratio (>1) (p = 0.04). EGb761 inhibited HSP27 expression and migratory ability of A549/H441 cells, which is the same as HSP27-siRNA transfection effect. Moreover, EGb761 treatment activated the AKT and p38 pathways and did not affect the expression of PI3K, ERK, and JNK pathways. HSP27 is a poor prognostic indicator of NSCLC. EGb761 can decrease the migration ability of A549/H441 by inhibiting HSP27 expression most likely through AKT and p38 MAPK pathways activation.

Magnolol induces apoptosis via caspase-independent pathways in non-small cell lung cancer cells.

Magnolol, a hydroxylated biphenyl agent isolated from herbal planet Magnolia officinalis, is a component of traditional Asian herbal teas. It has been reported to have anti-microbial, anti-inflammatory, and anti-cancer activity. Non-small cell lung cancer (NSCLC) cell lines (A549, H441 and H520) and normal human bronchial epithelial cells (HBECs) were used to evaluate the cytotoxic effect of magnolol. We show that magnolol inhibited cellular proliferation, increased DNA fragmentation, and decreased mitochondrial membrane potential in all NSCLC cells, but had no cytotoxic effect on HBECs. Magnolol triggered the release of pro-apoptotic proteins: Bid, Bax and cytochrome c from mitochondria, but did not activate the caspase-3, -8, and -9, suggesting that magnolol induces apoptosis of NSCLC cell lines via a caspase-independent pathway. The caspase-independent pathway is mediated through the activation of nuclear translocation of apoptosis-inducing factor, endonuclease G and cleaved poly(ADP-ribose) polymerase, which played important roles in mediating cell death. Furthermore, magnolol inhibited PI3K/AKT and ERK1/2 activity, but up-regulated p38 and JNK activity in A549 cell lines. The results of this study provided a basis for understanding and developing magnolol as a novel treatment of NSCLC.

High expression of heme oxygenase-1 is associated with tumor invasiveness and poor clinical outcome in non-small cell lung cancer patients.

BACKGROUND: Heme oxygenase-1 (HO-1), a rate-limiting enzyme in heme catabolism, is known to play a role in the protection of cells against oxidative stress, inflammation, anomalous proliferation and apoptosis. As yet, the role of HO-1 expression in non-small cell lung cancer (NSCLC) development and metastasis remains unclear and insufficient data are available regarding its impact on the prognosis of NSCLC patients. METHODS: Seventy NSCLC patients who underwent surgical resection were included in this HO-1 expression study and, concomitantly, clinical parameters were collected. Two lung adenocarcinoma cell lines (A549 and H441) were used to assess both invasive and migratory parameters in vitro. RESULTS: NSCLC patients with a high HO-1 expression ratio (tumor tissue/normal tissue) (> 1) exhibited a significantly poorer prognosis and a higher metastatic rate compared to those with a low HO-1 expression ratio (p < 0.05). The invasive and migratory abilities of A549 and H441 cells significantly increased after exogenous HO-1 over-expression and significantly decreased after siRNA-mediated HO-1 expression silencing. HO-1 up- and down-regulation also positively correlated with the expression of metastasis-associated proteins EGFR, CD147 and MMP-9. In addition, we found that HO-1 expression can be inhibited by PI3K and AKT inhibitors, but not by MAPK inhibitors. CONCLUSIONS: HO-1 is a poor prognostic NSCLC predictor and its over-expression may increase the metastatic potential of NSCLC. Based on our findings and those of others, HO-1 may be considered as a novel NSCLC therapeutic target.

Initial presentations predict mortality in pulmonary tuberculosis patients--a prospective observational study.

BACKGROUND: Despite effective anti-TB treatments, tuberculosis remains a serious threat to public health and is associated with high mortality. Old age and multiple co-morbidities are known risk factors for death. The association of clinical presentations with mortality in pulmonary tuberculosis patients remains an issue of controversy. METHODS: This prospective observational study enrolled newly diagnosed, culture-proven pulmonary tuberculosis patients from five medical centers and one regional hospital, which were referral hospitals of TB patients. Radiographic findings and clinical symptoms were determined at the time of diagnosis. Patients who died for any reason during the course of anti-TB treatment were defined as mortality cases and death that occurred within 30 days of initiating treatment was defined as early mortality. Clinical factors associated with overall mortality and early mortality were investigated. RESULTS: A total of 992 patients were enrolled and 195 (19.7%) died. Nearly one-third (62/195, 31.8%) of the deaths occurred before or within 30 days of treatment initiation. Older age (RR = 1.04, 95%CI: 1.03-1.05), malignancy (RR = 2.42, 95%CI: 1.77-3.31), renal insufficiency (RR = 1.77, 95%CI: 1.12-2.80), presence of chronic cough (RR = 0.63, 95%CI: 0.47-0.84), fever (RR = 1.45, 95%CI: 1.09-1.94), and anorexia (RR = 1.49, 95%CI: 1.07-2.06) were independently associated with overall mortality. Kaplan-Meier survival analysis demonstrated significantly higher mortality in patients present with fever (p<0.001), anorexia (p = 0.005), and without chronic cough (p<0.001). Among patients of mortality, those with respiratory symptoms of chronic cough (RR = 0.56, 95%CI: 0.33-0.98) and dyspnea (HR = 0.51, 95%CI: 0.27-0.98) were less likely to experience early mortality. The radiological features were comparable between survivors and non-survivors. CONCLUSIONS: In addition to demographic characteristics, clinical presentations including the presence of fever, anorexia, and the absence of chronic cough, were also independent predictors for on-treatment mortality in pulmonary tuberculosis patients.

Alveolar hemorrhage after scuba diving: a case report.

Self-contained underwater breathing apparatus (scuba) diving is increasingly popular in Taiwan. There are few references in the literature regarding pulmonary hemorrhage as the sole manifestation of pulmonary barotrauma in scuba divers, and no study from Taiwan was found in the literature. We present the case of a 25-year-old man who suffered alveolar hemorrhage related to pulmonary barotrauma as a complication of scuba diving. To our knowledge, this is the first case report describing a Taiwanese subject suffering from non-fatal pulmonary hemorrhage after scuba diving.

Decreased expression of thrombomodulin is correlated with tumor cell invasiveness and poor prognosis in nonsmall cell lung cancer.

Thrombomodulin (TM) plays a role in coagulation, inflammation, and cell adhesion. Reduction of TM expression plays an important role in the tumor metastatic process; however, insufficient information is available regarding the expression of TM in nonsmall cell lung cancer (NSCLC). Sixty NSCLC patients who underwent surgery were reviewed for TM expression and multiple variables were assessed by univariate and multivariate analyses. The expression level of TM and its metastatic ability were examined in vitro using the human NSCLC A549 cell line. TM expression in NSCLC was significantly correlated with survival; the 5-yr survival rates of patients with high and low TM expression were 23% and 18% (P < 0.01), respectively. Distribution of TM was detected predominantly in the normal lung tissue compared with lung cancer tissue. Western blot analysis showed, on average, decreased expression levels of TM protein in the lung cancer tissues of patients with NSCLC. An in vitro study also showed that overexpression of TM can inhibit the invasiveness and migration ability of the A549 cell line, whereas silencing of TM significantly enhanced these processes. This inhibition of cellular migration by overexpression of TM was significantly prevented by the selective inhibitors of PI3K and Akt, but not by MAPK inhibitors. This study demonstrates that a decrease in TM expression may be an indicator in the prognosis of NSCLC patients and provides new insights into the molecular mechanisms of TM in the metastasis of NSCLC.

Resveratrol inhibits human lung adenocarcinoma cell metastasis by suppressing heme oxygenase 1-mediated nuclear factor-kappaB pathway and subsequently downregulating expression of matrix metalloproteinases.

Resveratrol exhibits potential anti-carcinogenic activities. Heme oxygenase-1 (HO-1) is involved in angiogenesis and tumor metastasis. Matrix metalloproteinases (MMPs) are key enzymes in the degradation of extracellular matrix, and their expression may be dysregulated in lung cancer metastasis. In this study, we investigated the anti-invasive mechanism of resveratrol in lung cancer cells. HO-1 was shown to be elevated (approximately 4.7-fold) in lung cancer tumor samples as compared with matched normal tissues. After treatment of lung adenocarcinoma cell line A549 cells with resveratrol (50 microM) for 24 h, the migratory and invasive abilities (38 and 30% inhibition, respectively) of A549 cells were significantly reduced. Resveratrol significantly inhibited HO-1-mediated MMP-9 (35% inhibition) and MMP-2 (28% inhibition) expression in lung cancer cells. Nuclear factor (NF)-kappaB inhibitor induced a marked reduction in MMP-9 and MMP-2 expression, suggesting NF-kappaB pathway could play an important role. Furthermore, HO-1 inhibition and silencing significantly suppressed MMPs and invasion of lung cancer cells. Our results suggest that resveratrol inhibited HO-1 and subsequently MMP-9 and MMP-2 expression in lung cancer cells. The inhibitory effects of resveratrol on MMP expression and invasion of lung cancer cells are, in part, associated with the HO-1-mediated NF-kappaB pathway.

Management of a nosocomial outbreak of Mycobacterium tuberculosis Beijing/W genotype in Taiwan: an emphasis on case tracing with high-resolution computed tomography.

A nosocomial outbreak of Mycobacterium tuberculosis Beijing/W genotype infected 15 healthcare workers (HCWs) in a medical center in Taiwan, where there is a high prevalence of tuberculosis and a high rate of positive tuberculin skin tests. An index patient with laryngeal cancer and a lung abscess was identified by epidemiological investigation and it was found that an M. tuberculosis isolate from his lung tissue sample had an identical IS6110 restriction fragment length polymorphism pattern to the isolates from 3 HCWs. Confirmation of the identity of this strain as Beijing/W genotype was made using spoligotyping. Seven hundred and eighty-five HCWs potentially exposed to the probable index patient received contact investigation and chest X-ray screening. We used chest high-resolution computed tomography (HRCT) to clarify trivial lesions in chest X-rays. Nine HCWs with smear-negative pulmonary tuberculosis were diagnosed by HRCT. Fifteen of the 35 (42.9%) HCWs with documented exposure to the index patient developed pulmonary tuberculosis within 11 months after exposure. The outbreak was successfully controlled by active case finding and enforcement of infection control strategies. Intervention to detect the potential tuberculosis source is helpful in the prevention and control of a nosocomial tuberculosis outbreak. HRCT can be a useful tool for tuberculosis diagnosis of contacts in an outbreak situation.

Second-hand smoke and chronic bronchitis in Taiwanese women: a health-care based study.

BACKGROUND: Cigarette smoking cannot fully explain the epidemiologic characteristics of chronic obstructive pulmonary disease (COPD) in women, particularly for those who rarely smoke, but COPD risk is not less than men. The aim of our study is to investigate the relationship between second-hand smoke (SHS) exposure and chronic bronchitis in Taiwanese women. METHODS: We used Taiwan's National Health Insurance Bureau claims data in 1999, and cross-checked using criteria set by the American Thoracic Society; there were 33 women with chronic bronchitis, 182 with probable chronic bronchitis, and 205 with no chronic bronchitis during our interview time between 2000 and 2005. We measured second-hand smoke (SHS) exposure by self-reported measures (household users and duration of exposure), and validated this by measuring urinary cotinine levels of a subset subjects. Classification of chronic bronchitis was also based on spirometry defined according to the GOLD guidelines to get the severity of COPD. RESULTS: Women who smoked and women who had been exposed to a lifetime of SHS were 24.81-fold (95% CI: 5.78-106.38) and 3.65-fold (95% CI: 1.19-11.26) more likely to have chronic bronchitis, respectively, than those who had not been exposed to SHS. In addition, there was a significant increasing trend between the severity of COPD and exposure years of SHS (p < 0.01). The population attributable risk percentages of chronic bronchitis for smokers and those exposed to SHS were 23.2 and 47.3% respectively. CONCLUSIONS: These findings indicate that, besides cigarette smoking, exposure to SHS is a major risk factor for chronic bronchitis in Taiwanese women.

High-mobility group box 1-mediated matrix metalloproteinase-9 expression in non-small cell lung cancer contributes to tumor cell invasiveness.

High-mobility group box 1 (HMGB1) is a versatile protein with intranuclear and extracellular functions. It is involved in invasion and metastasis in various human malignancies. However, the role of HMGB1 in non-small cell lung cancer (NSCLC) is unclear. We hypothesized that HMGB1 expression is a determinant of cellular invasiveness and metastasis in lung cancer. We examined HMGB1 expression in 48 NSCLC specimens by quantitative real-time PCR. High HMGB1 expression was significantly associated with clinically advanced stages (stage III-IV) (P < 0.05) and was correlated to expression of matrix metalloproteinase-9 (MMP-9) (P < 0.05). Patients with high levels of HMGB1 expression had poorer clinical prognosis. The expression level of MMP-9 and metastatic ability in vitro were significantly higher in an HMGB1-overexpressing human NSCLC cell lines (A549 and H23). The treatment with HMGB1 small interfering RNA reduced MMP-9 expression and the cellular metastatic ability in NSCLC cells. We also demonstrated that phosphoinositide 3-kinase/Akt and NF-κB-related pathways contributed to the HMGB1-induced MMP-9 expression and cellular metastatic ability.

Combined lung fibrosis and 'mechanic's hand': a clinical diagnostic clue to amyopathic antisynthetase syndrome.

Combined interstitial lung disease and the presence of 'mechanic's hands' could be a clinical clue in the early diagnosis of the rare disease, amyopathic antisynthetase syndrome for which anti-Jo-1 antibody is a useful diagnostic tool. The case is reported of a patient who suffered from shortness of breath and dry cough, with pulmonary fibrosis on CXR and CT scan, and interstitial pneumonitis on trans-bronchial biopsy. She was also positive for anti-Jo-1 and anti-Ro antibodies. 'Mechanic's hands' were noted bilaterally but with no evidence of myopathy in either the electromyogram or on muscle biopsy. The patient was treated with prednisolone and her clinical picture, including the 'mechanic's hands' and lung fibrosis, subsided gradually, suggesting that the sign may be a useful follow up tool in this disease. Early diagnosis and corticosteroid therapy could be beneficial for these patients.

Lack of associations between several polymorphisms in cytokine genes and the risk of chronic obstructive pulmonary diseases in Taiwan.

Cytokine-induced inflammation is the predominant underlying mechanism in chronic obstructive pulmonary disease (COPD). Genetic factors may play a pivotal role in the development of this disease. This study looked at the relationship between COPD and genetic polymorphisms in the genes encoding some of these cytokines in a Taiwanese population. The genetic polymorphisms examined in this study were tumor necrosis factor (TNF)-alpha(-308), TNF-alpha(+489), interleukin(IL)-1beta(-31), interleukin-1 receptor antagonist (IL-1 RN), and IL-6(-174). In total, 30 patients with COPD, 64 subjects at risk of COPD and 115 controls were recruited to the study between 1999 and 2003. DNA was collected from these subjects and analyzed by polymerase chain reaction with sequence-specific primers and restriction enzyme fragment length polymorphism analysis. The frequencies of cytokine genotypes in COPD cases and controls, respectively, were as follows: for G/G in TNF-alpha(-308), 76.7% and 83.5%; for G/G in TNF-alpha(+489), 76.7% and 68.7%; for C/T in IL-1beta(-31), 60.0% and 55.7%; for 4R/4R in IL-1 RN, 80.0% and 86.1%; and for G/G in IL-6(-174), 100.1% and 98.3%. There was no difference in the distribution of the frequencies of these genotypes and alleles between COPD cases and controls. Moreover, no association was found between these genetic polymorphisms in cytokines and COPD (regardless of COPD subtypes) with respect to cigarette smoking or pulmonary function tests. Despite this, smoking is still an important risk factor for developing COPD.

A case of dermoid cyst ruptured into the lung.

Ruptured cystic teratomas (dermoid cysts) are rare and always symptomatic, presenting as haemothorax, pleural effusion or pericardial effusion. We present an extremely rare case of a 45-year-old woman who, during a routine health assessment was noted to have a well-defined anterior mediastinal tumour with peripheral ground glass opacity on chest CT. The patient was asymptomatic. She underwent video-assisted thoracoscopic surgery and a ruptured dermoid cyst was observed and the contents had infiltrated into the right pulmonary parenchyma. There were no complications and no evidence of recurrence 10 months later. Despite most cystic teratomas being asymptomatic and benign, rupture into the pulmonary parenchyma may induce further damage, for which emergency surgical intervention is always necessary.

Routine culture for Mycobacterium tuberculosis from bronchoscopy in Taiwan.

BACKGROUND AND OBJECTIVE: The value of routine culture for mycobacterium from bronchoscopic washings and the cost-effectiveness is still uncertain in countries where tuberculosis is endemic. This study examined the epidemiology of positive cultures for M. tuberculosis obtained by bronchoscopy to determine the health benefit and cost of a policy of routine culture and smear. METHODS: All positive cultures for Mycobacterium tuberculosis in bronchial washings and the corresponding CXR features were analysed. RESULTS: The incidence of tuberculosis in routine bronchoscopy was 3.71%, and in patients who presented with typical tuberculosis features on CXR was 6.5%. Up to 10.6% of culture-proven pulmonary tuberculosis relied on bronchoscopy for diagnosis. The total cost of routine mycobacterium culture and acid-fast bacillus smear during the 2-year period was approximately US $24,800. CONCLUSION: Routine mycobacterium culture and acid-fast staining from bronchoscopic specimens appears to be valuable in countries where tuberculosis is prevalent.

Detection of activated K-ras in non-small cell lung cancer by membrane array: a comparison with direct sequencing.

The ability to detect K-ras oncogene may provide additional information for the management of patients with non-small cell lung cancer (NSCLC). In the present study, we detected the K-ras oncogene in 76 patients with NSCLC by two methods: direct sequencing of K-ras in tumor tissues and membrane array detection of the gene overexpression specific for activated K-ras in peripheral blood. The results showed that 28 (36.8%) of the 76 Taiwanese NSCLC patients had K-ras mutations, with a frequency of 36.4% (20/55) in adenocarcinomas and 38.1% (8/21) in squamous cell carcinomas. The K-ras mutations were more frequently found in smokers than in non-smokers (51.4 vs. 24.4%, P=0.015). The incidences of K-ras mutation in the subgroups of non-smokers and squamous cell carcinomas are relatively higher in Taiwan than in other countries. On the other hand, the membrane array method could positively detect circulating activated K-ras in all of the 27 NSCLC patients with K-ras mutations at codons 12, 13 and 61, and in 4 of the 48 patients with wild-type K-ras. Our results suggest that the K-ras oncogene membrane array serves as a sensitive and convenient tool for the detection of K-ras oncogene, and therefore, has a great potential for clinical applications.

Differential expression profile of MAGE family in non-small-cell lung cancer.

The expression of the melanoma-associated antigen (MAGE) genes consists of variables in all tumor types, such as lung cancer, which are relevant to be silent in all normal tissues except germ cells. They are considered as tumor-specific antigens, and are ideal targets for cancer immunotherapy. A complete MAGE genes differential expression profile analysis of lung cancer can provide this study not only various target genes for immunotherapy, but also valuable markers for further diagnosis and prognosis. This research has constructed a membrane array, which was consisted 32 MAGE genes, to detect whether the differential expression profile occurred in 52 pairs of non-small-cell lung cancer (NSCLC) samples. Nearly 32 MAGE genes have been differential expressed in NSCLC except MAGE-B1 and -E2. MAGE-B, -C, -D, and subgroup -B6, -D4 have showed prominences in lung adenocarcinoma. High-frequent expression of MAGE-D, and subgroup -A2, -D2 has also been discovered in non-metastasis group (p<0.05). However, there is no significant difference of MAGE genes differential expression shown among different primary tumor (T), nodal involvement (N) and overall stages. Several MAGE subgroup genes, such as MAGE-A5, -A7, -A8, -A9, -A11, -B3, -B4, -B10, -D2, -D3, -F1, -G1, -H1, and -L2, have been first discovered to show differential expression in NSCLC. Although the small size of the sample may limit the diagnostic and prognostic value of MAGE genes, the function of the membrane array can provide this study a high-throughput method to detect the whole MAGE genes differential expression profile.

A simple modification of Ciaglia Blue Rhino technique for tracheostomy: using a guidewire dilating forceps for initial dilation.

OBJECTIVE: The potential difficulty in doing initial dilation in the percutaneous dilational tracheostomy (PDT) with the Ciaglia Blue Rhino (CBR) technique has been reported by others and encountered in our clinical practice. To resolve this problem, we developed a modified CBR technique by using a guidewire dilating forceps (GWDF) to facilitate initial dilation. The present before-and-after comparison study aimed to evaluate the clinical benefits of this modified CBR technique. METHODS: Consecutive 120 patients undergoing CBR technique in the pre-conversion year and 114 patients undergoing GWDF-CBR technique in the post-conversion year were enrolled for analysis. The procedure time and procedure-related complications were compared between these two groups. RESULTS: The mean procedure time with GWDF-CBR technique was 4.5+/-1.6min, significantly shorter than 5.7+/-3.0min with CBR technique (p<0.001). Only two patients in the GWDF-CBR group required prolonged procedure time (>8min), compared with 14 patients in the CBR group. Thirty three (27.5%) of 120 patients undergoing CBR technique and 15 (13.1%) of 114 patients undergoing GWDF-CBR technique had PDT-related complications (p=0.006). Most of the complications were minor and transient. Only 13 patients in the CBR group and 3 patients in the GWDF-CBR group encountered major complications (10.8% vs 2.6%, p=0.012). Regarding the high-risk patients, 21 (36.2%) of 58 patients in the CBR group and 9 (15.8%) of 57 patients in the GWDF-CBR group had PDT-related complications (p=0.011). CONCLUSIONS: Pre-dilation with a GWDF in the CBR technique helped to prevent prolonged procedure time and procedure-related complications. We suggest that the bronchoscopy-guided GWDF-CBR serves an easy-to-operate and relatively safe PDT technique for critically ill patients.

Great potential of a panel of multiple hMTH1, SPD, ITGA11 and COL11A1 markers for diagnosis of patients with non-small cell lung cancer.

Research on molecular mechanisms underlying the carcinogenesis of non-small cell lung cancer (NSCLC) may provide gene targets in critical pathways valuable for improving the efficacy of therapy and survival of patients with NSCLC. However, the molecular markers highly sensitive for the prognosis and treatment evaluation of NSCLC are not yet available. To explore candidates, we conducted an oligonucleotide microarray study with three pairs of NSCLC and normal lung tissue, and determined 8 differentially expressed genes including the Human MutT homologue (hMTH1), Surfactant protein D (SPD), Human hyaluronan binding protein 2 (HABP2), Crystalline-mu (CRYM), Ceruloplasmin (CP), Integrin alpha-11 subunit (ITGA11), Collagen type XI alpha I (COL11A1), and Lung-specific X protein (Lun X). Four lung cancer-related markers MUC-1, hTERT, hnRNP B1, and CK-19 were also incorporated for further analysis. The expression profiles of the twelve genes in seventy pairs of NSCLC tumor and normal lung tissue were then detected quantitatively by using membrane array and quantitative real-time PCR (qRT-PCR). The data of the membrane array and qRT-PCR were compared for consistency and the potential of these mRNA markers in clinical application. The results showed that membrane array and qRT-PCR obtained consistent data for the tested genes in both sensitivity and specificity (correlation coefficient 0.921, p<0.0001). For patients' clinicopathological characteristics, the overexpression of hMTH1, SPD, HABP 2, ITGA11, COL11A1, and CK-19 was significantly correlated with the pathological stage (p<0.05). In addition, the overexpression of hMTH1, SPD, ITGA11, and COL11A1 was correlated with lymph node metastasis and poor prognosis. This is the first report relating SPD to a prognosis marker for NSCLC. Moreover, the combined detection of these four mRNA markers by membrane array had a sensitivity of 89% and a specificity of 84% for NSCLC, significantly higher than these markers had achieved separately. In conclusion, we identified mRNA markers for NSCLC prognosis and therapy evaluation from differentially expressed genes determined by using micro-array. Further studies are needed to collect the data of the mRNA markers used in clinical practice.