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Specifically, TIMP-3 LOH and promoter hypermethylation were more prevalent in HPV16/18�Cinfected tumors than in noninfected tumors (40% versus 17%, P = 0.001 for LOH; 51% versus 30%, P = 0.005 for promoter methylation). TIMP-3 expression was less common in E6-positive tumors than in E6-negative tumors (39% versus 61%, P = 0.004). As expected, TIMP-3 LOH, promoter methylation, and low TIMP-3 expression were more prevalent in HPV16/18 E6 expression tumors. These results strongly suggest that high frequency of TIMP-3 loss by LOH and promoter hypermethylation may be linked to HPV16/18 infection. Chronic hepatic inflammation induced by IL-6 production has been shown in TIMP-3 knockdown mice.28 Therefore, we tested whether EPZ5676 IL-6 expression could be related to HPV16/18 infection and E6 and TIMP-3 expression in lung tumors. Immunohistochemical data showed that tumors with high IL-6 expression were more prevalent in HPV16/18�Cpositive patients than in HPV16/18�Cnegative patients (85% versus 60%, P = 0.008; Table 3). As expected, high IL-6 expression was more prevalent in HPV16/18 E6�Cpositive than in HPV16/18 E6�Cnegative tumors ( Table 3). IL-6 expression was negatively associated with TIMP-3 expression (62% versus 82%, P = 0.024). We also observed that the prevalence of high IL-6 expression in patients with selleck chemicals llc low TIMP-3 plus E6 positivity was greater than for the other three combinations (P = 0.001; Table 3). The same phenomenon was seen in patients with low TIMP-3 plus E6 positivity (P = 0.012; Table 3). These results indicate that IL-6 expression is positively correlated with E6 positivity and TIMP-3 loss in lung tumors. We examined whether E6, TIMP-3, and IL-6 could be associated with OS and RFS in lung cancer. In this study population, no patients received adjuvant chemotherapy before surgical resection, and 147 patients were available for estimation of MAPK relapse-free survival. The mean follow-up period after surgery was 59.3 months. The median survival times were 27.2 months for OS and 21.2 months for RFS. During the survey, 121 patients died. Among the 147 patients with tumor relapse follow-up data, 59 patients experienced relapse. As expected, the prognostic value of tumor stage on OS and RFS, determined by Kaplan-Meier and multivariate Cox regression models, was observed in this study population (see Supplemental Tables S1 and S2 at http://ajp.amjpathol.org). In addition, a poorer OS and RFS in lung adenocarcinoma compared with squamous cell carcinoma was revealed after multivariate Cox regression analysis (P = 0.016) (see Supplemental Table S2 available at http://ajp.amjpathol.org). Kaplan-Meier analysis showed that HPV16/18 infection and E6 expression was not associated with OS or RFS in this study population (see Supplemental Figure S1 at http://ajp.amjpathol.org). Patients with low TIMP-3 expression had shorter OS and RFS than those with high TIMP-3 expression (P

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