The combined expression of metaplasia biomarkers predicts the prognosis of gastric cancer

Yun Suhk Suh, Hyuk Joon Lee, Eun Jung Jung, Min A. Kim, Ki Taek Nam, James R. Goldenring, Han Kwang Yang, Woo Ho Kim

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Abstract

Background. Our previous study indicated that gene expression profiling of intestinal metaplasia (IM) or spasmolytic polypeptide-expressing metaplasia (SPEM) can identify useful prognostic markers of early-stage gastric cancer, and seven metaplasia biomarkers (MUC13, CDH17, OLFM4, KRT20, LGALS4, MUC5AC, and REG4) were selectively expressed in 17-50% of gastric cancer tissues. We investigated whether the combined expression of these metaplasia biomarkers could predict the prognosis of advanced stage gastric cancer. Methods. The expression of seven metaplasia biomarkers was evaluated immunohistochemically using tissue microarrays comprised of 450 gastric cancer patients. The clinicopathologic correlations and the prognostic impact were analyzed according to the expression of multiple biomarkers. Results. MUC13, CDH17, LGALS4, and REG4 were significant prognostic biomarkers in univariate analysis. No expression of four markers was found in 56 cases (14.2%); 1 marker was seen in 67 cases (17%), 2 in 106 cases (27%), 3 in 101 cases (25.7%), and 4 in 63 cases (16%). Patients in which two or fewer proteins were expressed (group B) showed younger age, undifferentiated or diffuse type cancer, larger tumor size, larger number of metastatic lymph nodes, and more advanced stage than those in which three or more proteins were expressed (group A). In undifferentiated or stage II/III gastric cancer, the prognosis of group B was significantly poorer than that of group A by multivariate analysis. Conclusions. The combined loss of expression of multiple metaplasia biomarkers is considered an independent prognostic indicator in undifferentiated or stage II/III gastric cancer.

Original languageEnglish
Pages (from-to)1240-1249
Number of pages10
JournalAnnals of surgical oncology
Volume19
Issue number4
DOIs
Publication statusPublished - 2012 Apr 1

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All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Suh, Y. S., Lee, H. J., Jung, E. J., Kim, M. A., Nam, K. T., Goldenring, J. R., Yang, H. K., & Kim, W. H. (2012). The combined expression of metaplasia biomarkers predicts the prognosis of gastric cancer. Annals of surgical oncology, 19(4), 1240-1249. https://doi.org/10.1245/s10434-011-2125-1