Kim Joori, Shin Kabsoo, Lee Sung Hak, Kim In-Ho
Division of Medical Oncology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Department of Clinical Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
J Gastrointest Oncol. 2021 Aug;12(4):1326-1337. doi: 10.21037/jgo-21-123.
Slug is an activating transcription factor involved in epithelial-mesenchymal transition, and CD133 is a cancer stem cell marker found in various cancers, including gastric cancer (GC). We investigated the relationship between Slug and CD133 and the occurrence of peritoneal carcinomatosis and survival in patients with GC.
This retrospective study included 196 patients with stage 2 or 3 GC who underwent curative surgery with D2 lymph node dissection and adjuvant chemotherapy between 2001 and 2009. We analyzed the expression of Slug, CD133, ABCG2, E-cadherin, vimentin, NEDD9, and SMAD4 in surgical tissue specimens using immunohistochemical analysis to determine their prognostic value.
Among the 196 patients, expression of Slug was elevated in 157 tumors (81%) while the expression of CD133 was high in 153 tumors (81%). The expression of Slug and CD133 in combination significantly predicted peritoneal relapse (P=0.002). High Slug and high CD133 expression were significantly associated with poor peritoneal relapse-free survival [hazard ratio (HR), 7.239; P=0.007] and overall survival (HR, 1.682; P=0.027) in multivariate Cox analysis.
Our study shows that a high Slug and high CD133 expression status is predictive of peritoneal recurrence in high-risk resected GC patients. They are also a poor prognostic factor for peritoneal relapse-free survival and overall survival.
Slug是一种参与上皮-间质转化的激活转录因子，CD133是在包括胃癌（GC）在内的多种癌症中发现的癌症干细胞标志物。我们研究了Slug与CD133之间的关系以及GC患者腹膜种植转移的发生情况和生存率。
这项回顾性研究纳入了196例2期或3期GC患者，这些患者在2001年至2009年间接受了D2淋巴结清扫的根治性手术及辅助化疗。我们使用免疫组织化学分析方法分析手术组织标本中Slug、CD133、ABCG2、E-钙黏蛋白、波形蛋白、NEDD9和SMAD4的表达，以确定它们的预后价值。
在196例患者中，157例肿瘤（81%）的Slug表达升高，153例肿瘤（81%）的CD133表达较高。Slug和CD133的联合表达显著预测了腹膜复发（P=0.002）。在多因素Cox分析中，高Slug和高CD133表达与较差的腹膜无复发生存率[风险比（HR），7.239；P=0.007]和总生存率（HR，1.682；P=0.027）显著相关。
我们的研究表明，高Slug和高CD133表达状态可预测高危切除GC患者的腹膜复发。它们也是腹膜无复发生存率和总生存率的不良预后因素。
