Manuel Del Casar José, Vizoso Francisco José, Abdel-Laa Omar, Sanz Lourdes, Martín Aranzazu, Daniela Corte María, Bongera Miguel, García Muñiz José Luis, Fueyo Antonio
Department of Surgery, Hospital de Jove, Gijón, Spain.
J Surg Oncol. 2004 Apr 1;86(1):16-21. doi: 10.1002/jso.20041.
Cathepsin D (Cath-D) is an aspartyl protease involved in protein catabolism and tissue remodelling. In the present article, we evaluate the tumor content of Cath-D in resectable gastric carcinomas and its relation with clinical and pathological parameters, as well as its prognostic significance.
This prospective study included a series of 60 patients with primary gastric adenocarcinoma, who first underwent a complete surgical resection of their tumors and then were evaluated for disease recurrence and survival status during a mean follow-up period of 41.5 months. Cath D was measured in cytosolic samples using an immune-radiometric assay which determined the total amount of Cath-D (52K, 48K, and 34K).
The tumor content of Cath-D ranged from 4 to 247 pmol/mg protein and from 6.4 to 97.7 pmol/mg protein in adjacent non-neoplastic mucosa samples. Cytosolic Cath-D levels were significantly higher in neoplastic tissues (P < 0.001). Statistical analysis also demonstrated that younger patients showed lower Cath-D tumor levels than older ones. Likewise, patients with lower tumor levels of Cath-D had better survival than those with intermediate or high Cath-D tumor content (P = 0.002). This finding showed an independent prognostic value on survival (P = 0.02).
The present study demonstrates the presence of higher Cath-D content in gastric carcinomas than in adjacent non-neoplastic mucosa, and that high intratumor Cath-D levels identify a subgroup of resectable gastric cancer patients with a high probability of relapse as well as worse survival.
组织蛋白酶D（Cath-D）是一种参与蛋白质分解代谢和组织重塑的天冬氨酸蛋白酶。在本文中，我们评估了可切除胃癌中Cath-D的肿瘤含量及其与临床和病理参数的关系，以及其预后意义。
这项前瞻性研究纳入了60例原发性胃腺癌患者，这些患者首先接受了肿瘤的完整手术切除，然后在平均41.5个月的随访期内评估疾病复发和生存状况。使用免疫放射分析测定细胞溶质样品中的Cath D，该分析确定了Cath-D（52K、48K和34K）的总量。
Cath-D的肿瘤含量在4至247 pmol/mg蛋白质之间，相邻非肿瘤黏膜样品中的含量在6.4至97.7 pmol/mg蛋白质之间。肿瘤组织中的细胞溶质Cath-D水平显著更高（P < 0.001）。统计分析还表明，年轻患者的Cath-D肿瘤水平低于老年患者。同样，Cath-D肿瘤水平较低的患者比Cath-D肿瘤含量中等或较高的患者生存更好（P = 0.002）。这一发现显示了对生存的独立预后价值（P = 0.02）。
本研究表明，胃癌中的Cath-D含量高于相邻的非肿瘤黏膜，并且肿瘤内Cath-D水平高可识别出一组可切除胃癌患者，这些患者复发概率高且生存较差。
