Epithelial and stromal syndecan-1 expression as predictor of outcome in patients with gastric cancer.
The prognostic value of the immunohistochemical expression of epithelial and stromal syndecan-1 was evaluated in 296 patients with gastric carcinoma. Formalin-fixed, paraffin-embedded specimens of gastric adenocarcinomas were stained with mouse monoclonal antibody B-B4 against human syndecan-1. Loss of immunoreactivity (syndecan-1 immunoreactivity correlated with a higher stage of disease (stages II-IV), tumour location in the upper third of the stomach, nodal metastases (N1 or N2), positive stromal syndecan-1 staining, deep tumour penetration (to subserosa or deeper = T2-T4), larger tumour size (> or = 5 cm) and intestinal type of cancer. No correlation between epithelial syndecan-1 immunoreactivity and age, gender, distant metastases, grade of differentiation or Borrmann classification was observed. Positive stromal syndecan-1 immunoreactivity correlated with decreased epithelial syndecan-1 expression, intestinal type of cancer and Borrmann type I. Patients with low epithelial syndecan-1 expression in cancer cells had worse overall survival than patients with strong epithelial syndecan-1 staining (p = 0.0012). Stromal syndecan-1-positive patients had a worse outcome than patients with syndecan-1-negative stroma (p = 0.0193). In Cox multivariate analysis, stromal syndecan-1 immunoreactivity was a prognostic factor independent of TNM stage, surgery for cure and tumour size. Thus, the immunohistochemical expression of syndecan-1 might be a predictor of outcome in patients with gastric adenocarcinoma.
Department of Surgery, University of Helsinki, Helsinki, Finland.
J P
JP
Wiksten
J
J
Lundin
S
S
Nordling
M
M
Lundin
A
A
Kokkola
K
K
von Boguslawski
C
C
Haglund
D000230:Adenocarcinoma / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000911:Antibodies, Monoclonal / Q000378:metabolism; D018450:Disease Progression; D004848:Epithelium / Q000378:metabolism*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis; D008297:Male; D008562:Membrane Glycoproteins / Q000096:biosynthesis*; D051379:Mice; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011509:Proteoglycans / Q000096:biosynthesis*; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000628:therapy*; D017154:Stromal Cells / Q000378:metabolism*; D053668:Syndecan-1; D053667:Syndecans; D013997:Time Factors; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D008562:Membrane Glycoproteins; D011509:Proteoglycans; C508241:SDC1 protein, human; C508242:Sdc1 protein, mouse; D053668:Syndecan-1; D053667:Syndecans