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接受根治性胃切除术的胃癌患者中ADAM17表达的预后意义

Prognostic significance of ADAM17 expression in patients with gastric cancer who underwent curative gastrectomy.

作者信息

Aydin D, Bilici A, Yavuzer D, Kefeli U, Tan A, Ercelep O, Mert A, Yuksel S, Ozcelik M, Isik D, Surmeli H, Odabasi H, Aliustaoglu M

机构信息

Department of Medical Oncology, Dr. Lutfi Kırdar Kartal Education and Research Hospital, Istanbul, Turkey,

出版信息

Clin Transl Oncol. 2015 Aug;17(8):604-11. doi: 10.1007/s12094-015-1283-1. Epub 2015 Mar 19.

Abstract

BACKGROUNDS

A disintegrin and metalloproteinase (ADAM) 17 has been indicated to be an indispensable regulator of cellular events from proliferation to migration. Although prognostic importance of ADAM17 expression has been investigated in several tumours, its clinical utility as a useful prognostic molecular marker remains unclear in gastric cancer. In the current study, we evaluated the expression of ADAM17 and its prognostic significance in gastric cancer patients after curative gastrectomy.

METHODS

The prognostic significance of ADAM17 expression was analysed immunohistochemically in 156 patients with gastric cancer who had undergone curative gastrectomy, and the relationship between its expression and clinicopathological factors was also evaluated.

RESULTS

High ADAM17 expression was detected in 79 patients (51 %), whereas low expression was found in 77 cases (49 %). There was significant correlation between gender, histology, lymph node metastasis, vascular invasion, the presence of recurrence and high ADAM17 expression. Recurrence in patients with high ADAM17 expression was significantly higher than that for patients with low ADAM17 expression (p = 0.032). The median disease-free survival (DFS) time for patients with tumours with high ADAM17 expression was worse than that of patients with tumours with low ADAM17 expression (16.6 vs. 44.2 months, p = 0.004). In addition, patients with low ADAM17 expression had a higher median overall survival (OS) (49.6 vs. 26.9 months, p = 0.019) compared to those with high ADAM17 expression. Multivariate analysis indicated that the rate of ADAM17 expression was an independent prognostic factor for DFS, in addition to the already known important clinicopathological prognostic indicator. But the prognostic importance of ADAM17 expression could not be proved by multivariate analysis for OS.

CONCLUSIONS

The potential value of ADAM17 expression as a useful molecular marker in gastric cancer progression should be evaluated comprehensively; it may predict recurrence and poor prognosis in patients with gastric cancer after curative resection.

摘要

背景

解整合素金属蛋白酶17(ADAM17)已被证实是细胞从增殖到迁移等活动不可或缺的调节因子。尽管已对几种肿瘤中ADAM17表达的预后重要性进行了研究,但在胃癌中其作为有用的预后分子标志物的临床应用仍不明确。在本研究中,我们评估了ADAM17在胃癌患者根治性胃切除术后的表达及其预后意义。

方法

对156例行根治性胃切除术的胃癌患者进行免疫组化分析,以探讨ADAM17表达的预后意义,并评估其表达与临床病理因素之间的关系。

结果

79例患者(51%)检测到ADAM17高表达,77例患者(49%)为低表达。性别、组织学类型、淋巴结转移、血管侵犯、复发情况与ADAM17高表达之间存在显著相关性。ADAM17高表达患者的复发率显著高于低表达患者(p = 0.032)。ADAM17高表达肿瘤患者的无病生存期(DFS)中位数比低表达肿瘤患者差(16.6个月对44.2个月,p = 0.004)。此外,与ADAM17高表达患者相比,低表达患者的总生存期(OS)中位数更高(49.6个月对26.9个月,p = 0.019)。多因素分析表明,除了已知的重要临床病理预后指标外,ADAM17表达率是DFS的独立预后因素。但多因素分析未能证实ADAM17表达对OS的预后重要性。

结论

应全面评估ADAM17表达作为胃癌进展中有用分子标志物的潜在价值;它可能预测胃癌根治性切除术后患者的复发和不良预后。

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