Centre for Cancer Biomarkers CCBIO
CCBIO doctoral graduate

Prognostic biomarkers in non-small cell lung cancer

Maria Paula Ramnefjell defended April 10th 2018 her doctoral thesis "Prognostic biomarkers and clinico-pathologic characteristics in non-small cell lung cancer. A study with special focus on tumor-vascular interactions" at the University of Bergen.

Group photo of the candidate with opponents and supervisors.
The candidate with supervisors and evaluation committee. From the left: Lars A. Akslen, Lars Helgeland, Maria Ramnefjell, Åslaug Helland, Patrick Micke, Silke Appel.
Ole J. Halvorsen

Main content

Biomarkers in lung cancer

Lung cancer is a common form of cancer in both men and women. Despite several new treatment options in recent years, mortality rates remain high. There is a clear need for new and improved biomarkers that can contribute to targeted treatment decisions.

Investigating proliferation signs and protein markers

In this research project, various features of lung cancer tumors have been investigated, including blood and lymphatic vascular invasion, as early signs of proliferation. Such changes have been found to have high prognostic value, particularly in the two largest subgroups of non-small cell lung cancer; adenocarcinoma and plate epithelial carcinoma.

Ramnefjell also investigated expression of protein markers in the cancer cells, which previously have been shown to have a function in relation to the tumors’ ability to invade surrounding tissues and spread to other parts of the body. The group found that low expression of one of these proteins, SerpinB2, was associated with poorer patient survival.

A new marker of active blood vessel formation

Formation of new vessels (angiogenesis) has been associated with tumor growth and spread in many cancers, including lung cancer. In this project, a new marker of active blood vessel formation (Nestin-Ki67) in adenocarcinomas, expressed as vascular proliferation index, was found to be associated with aggressive tumor characteristics such as blood vessel infiltration. High vascular proliferation index was associated with poorer lung cancer-specific survival.

The findings have provided increased knowledge of lung cancer, and the studies can contribute to a better understanding of the interaction between tumor cells and the surrounding micro environment.

Personal background

Maria Ramnefjell (b. 1975) grew up at Kolbotn outside Oslo. She got her medical degree at the University of Bergen in 2002, became a specialist in pathology in 2011, and is currently working as senior consultant at the Department of Pathology, Haukeland University Hospital. Her doctoral thesis work was done at CCBIO, the Department of Clinical Medicine and Gade's Laboratory of Pathology, University of Bergen, in the period 2014-2017. Main supervisor has been Professor Lars A. Akslen, and Associate Professor Lars Helgeland has been co-supervisor.