Recently, new treatments are developed based on novel molecular biomarkers 7. For advanced NSCLC patients, platinum-based doublet chemotherapy remains the first-line therapy but the effectiveness is unsatisfactory mainly because of the non-responsiveness or resistance to chemotherapeutic drugs 6. Therefore, identification of novel and specific biomarkers with clinicopathological and prognostic significance is necessary for NSCLC management.Īlthough surgery, radiation therapy and chemotherapy can prolong the 5-year survival rate of NSCLC patients, especially for those at early-stages 5, most NSCLC patients are diagnosed at advanced-stages due to asymptomatic characteristics and lack of effective biomarkers. Even Carcinoembryonic antigen (CEA) and CA125 have been identified as diagnostic protein biomarkers for lung cancer 4, the sensitivity and specificity are not adequate for clinical use. Meanwhile, identifying high-quality cancer prognostic biomarkers is helpful to predict the outcome of different cancer patients and to avoid overtreatment to those patients at early stage 3. Understanding the carcinogenic mechanisms of lung cancer may help to find a biomarker and further develop treatment approaches to improve the cure and survival rates of this cancer. Non-small cell lung cancer (NSCLC) accounts for about 85% of all lung cancer and adenocarcinoma (ADC) is the most common histologic subtype 2. The 5-year survival rate of lung cancer is only 18% 1. Despite advances in early detection and standard treatment, lung cancer still has high recurrence rate (14%) and high mortality rate (27%) which is due to dimness of the pathogenesis of lung cancer. Lung cancer, with increasing morbidity and mortality, is currently the most common cause of cancer-related death worldwide.

Therefore, ROR1 expression significantly correlates with malignant attributes of lung ADC and it may serve as a novel prognostic marker in lung ADC patients. Multivariate COX regression analysis further confirmed that ROR1 is an independent prognostic predictor ( P < 0.001, HR = 4.114, 95% CI: 2.513–6.375) for OS. Kaplan-Meier survival analysis indicated an association of high ROR1 expression with worse overall survival (OS) in lung ADC patients ( P < 0.001). Moreover, Chi-square test showed that ROR1 expression was correlated to gender ( P = 0.028), the 7 th edition of the American Joint Committee on Cancer tumor-node-metastasis (AJCC TNM) staging system and lymph node metastasis ( P < 0.001). Patients at advanced stages and those with positive lymph node metastasis expressed higher level of ROR1 ( P < 0.001). The results revealed that ROR1 protein expression was significantly higher in lung ADC tissues than that in their adjacent non-tumor tissues. In this present study, Western blot analysis and immunohistochemistry were performed to characterize expression of ROR1 protein in lung ADC patients. This study aimed to examine the expression of ROR1 and evaluate its prognostic significance in human lung ADC patients. The receptor-tyrosine-kinase like orphan receptor 1 (ROR1) is reported to be overexpressed and associated with poor prognosis in several tumors. Currently, there is no reliable biomarker to clinically predict the prognosis of lung adenocarcinoma (ADC).

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