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Background  Biomarkers may help to improve non‐small cell lung cancer ( NSCLC ) prognosis. However, the prognostic effect of topoisomerase I (Topo I) on  NSCLC  is unknown. We evaluated the clinicopathologic and prognostic significance of tumor Topo I and thymidylate synthase ( TS ) protein expression in postoperative  NSCLC  patients.    Methods  One hundred and fifteen patients with postoperative  NSCLC  were enrolled. Topo I and  TS  protein were detected in removed tumors by  i mmunohistochemistry. The correlations between Topo  I/TS  protein expression and clinicopathologic characters and outcomes of patients were analyzed.    Results  Increased expression of Topo I was found in 57 (49.6%) tumors. The largest diameter of the tumor was significantly different between patients with high and low Topo I expression (  P   = 0.035).  TS  staining showed that 35 (30.4%) carcinomas were  TS  positive. The level of  TS  expression was correlated with tumor differentiation (  P   = 0.037). Patients with low Topo I expression had significantly longer overall survival ( OS ) than those with high expression (  P   = 0.004). The correlation between Topo I expression and  OS  was demonstrated among patients with squamous cell carcinoma (  P   = 0.030) and patients in pathological tumor node metastasis stage I (  P   = 0.027). Topo I expression was positively correlated with  TS  expression in tumor tissue (R = 0.251,   P   = 0.007).    Conclusions  Low Topo I expression is an independent favorable prognostic factor for longer  OS  in postoperative  NSCLC  patients, especially in squamous cell carcinoma. There is a correlation between the expression of  TS  and Topo I in removed tumor tissue.

Topoisomerase I expression is associated with prognosis in postoperative non‐small cell lung cancer patients