Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan,
World J Surg. 2014 Apr;38(4):910-7. doi: 10.1007/s00268-013-2359-0.
SIRT3-mitochondrial nicotinamide adenine dinucleotide-dependent deacetylase sirtuin-3-plays an important role in regulating cell metabolism and carcinogenesis. The role of SIRT3 in gastric cancer has not yet been investigated.
A total of 221 gastric cancer patients who underwent curative surgery were enrolled at the Department of Surgery, Taipei Veterans General Hospital. SIRT3 expression in gastric tissues and tumors were examined in these patients using immunohistochemical staining. Clinicopathologic characteristics and survival were analyzed and compared in gastric cancer patients with or without SIRT3 expression.
The 5-year survival rates of patients with or without SIRT3 expression were 51.2 and 39.1 %, respectively (p = 0.005). The 5-year disease-free survival rates of patients with or without SIRT3 expression were 49.6 and 38.0 %, respectively (p = 0.010). Microscopic features showed that there are more poor cell differentiation (p = 0.001), more diffuse-type Lauren's histology (p = 0.018), and more scirrhous-type stromal reactions (p = 0.027) in gastric cancer without SIRT expression. Multivariate analysis with overall survival as an endpoint showed that age (p < 0.001), Lauren's histology (p = 0.007), stromal reaction (p = 0.035), TNM pathologic N category (p < 0.001), and SIRT3 expression (p < 0.001) were significantly correlated with gastric cancer.
Gastric cancer patients with SIRT3 expression have a better prognosis than those without. SIRT3 expression is an independent prognostic marker for overall survival and may act as a tumor suppressor in gastric cancer.
SIRT3-线粒体烟酰胺腺嘌呤二核苷酸依赖性脱乙酰酶 SIRT3-在调节细胞代谢和致癌作用中发挥重要作用。SIRT3 在胃癌中的作用尚未得到研究。
共纳入 221 例在台北荣民总医院外科接受根治性手术的胃癌患者。采用免疫组织化学染色法检测这些患者胃组织和肿瘤中的 SIRT3 表达。分析和比较有或无 SIRT3 表达的胃癌患者的临床病理特征和生存情况。
有或无 SIRT3 表达的患者 5 年生存率分别为 51.2%和 39.1%（p = 0.005）。有或无 SIRT3 表达的患者 5 年无病生存率分别为 49.6%和 38.0%（p = 0.010）。镜下特征显示，无 SIRT 表达的胃癌中，细胞分化程度较差（p = 0.001）、弥漫型 Lauren 组织学类型（p = 0.018）和硬癌型基质反应（p = 0.027）更为多见。以总生存为终点的多变量分析显示，年龄（p < 0.001）、Lauren 组织学类型（p = 0.007）、基质反应（p = 0.035）、TNM 病理 N 分期（p < 0.001）和 SIRT3 表达（p < 0.001）与胃癌显著相关。
有 SIRT3 表达的胃癌患者预后较好。SIRT3 表达是总生存的独立预后标志物，可能在胃癌中起肿瘤抑制作用。
