Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Int J Surg. 2018 Apr;52:258-263. doi: 10.1016/j.ijsu.2018.02.055. Epub 2018 Mar 1.
Caspase-3 acts as a major executioner protein in proteolytic degradation during apoptosis. The role of Caspase-3 in gastric cancer remains controversial.
A total of 366 gastric cancer patients who received curative surgery were enrolled. Caspase-3 expression in gastric tumors was examined by immunohistochemical staining. Correlations between Caspase-3 expression and the survival rates and between Caspase-3 expression and the clinicopathological parameters of the gastric cancer patients were analyzed.
The 5-year overall survival rates of gastric cancer patients with and without Caspase-3 expression were 51.2% and 37.3%, respectively (P = 0.030). The 5-year disease-free survival rates of gastric cancer patients with and without Caspase-3 expression were 49.2% and 34.6%, respectively (P = 0.029). Analyses of the clinicopathological features showed that larger tumor size (P = 0.030), more advanced Borrmann type (P = 0.012), more aggressive stromal reaction (P = 0.001), higher classification using Ming's infiltrating histology type (P = 0.018), more lymph node involvement (P = 0.019), and more lymphovascular involvement (P = 0.045) were significantly correlated with a lack of Caspase-3 expression. The multivariate analysis showed that age (P = 0.001), Borrmann classification (P = 0.032), stromal reaction type (P = 0.018), TNM pathological T category (P = 0.002), TNM pathological N category (P < 0.001), and Caspase-3 expression (P = 0.041) were significantly correlated with the overall survival of gastric cancer patients.
Caspase-3 expression in gastric cancer patients is related to favorable clinicopathological features and a positive prognosis after curative surgery. Caspase-3 may act as a tumor suppressor in human gastric cancer.
Caspase-3 在细胞凋亡过程中作为主要的执行蛋白参与蛋白水解降解。Caspase-3 在胃癌中的作用仍存在争议。
共纳入 366 例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胃癌组织中 Caspase-3 的表达。分析 Caspase-3 表达与胃癌患者生存率之间的相关性，以及 Caspase-3 表达与胃癌患者临床病理参数之间的相关性。
有 Caspase-3 表达和无 Caspase-3 表达的胃癌患者的 5 年总生存率分别为 51.2%和 37.3%（P=0.030）。有 Caspase-3 表达和无 Caspase-3 表达的胃癌患者的 5 年无病生存率分别为 49.2%和 34.6%（P=0.029）。对临床病理特征的分析表明，肿瘤较大（P=0.030）、Borrmann 分型较高（P=0.012）、间质反应侵袭性较强（P=0.001）、Ming 浸润组织学分型分类较高（P=0.018）、淋巴结转移较多（P=0.019）和脉管侵犯较多（P=0.045）与 Caspase-3 表达缺失显著相关。多因素分析表明，年龄（P=0.001）、Borrmann 分型（P=0.032）、间质反应类型（P=0.018）、TNM 病理 T 分期（P=0.002）、TNM 病理 N 分期（P<0.001）和 Caspase-3 表达（P=0.041）与胃癌患者的总体生存率显著相关。
胃癌患者 Caspase-3 的表达与有利的临床病理特征和根治性手术后的良好预后相关。Caspase-3 可能在人类胃癌中作为一种肿瘤抑制因子发挥作用。
