Prognostic value of cytosolyc cathepsin D content in resectable gastric cancer.
OBJECTIVE
Cathepsin D (Cath-D) is an aspartyl protease involved in protein catabolism and tissue remodelling. In the present article, we evaluate the tumor content of Cath-D in resectable gastric carcinomas and its relation with clinical and pathological parameters, as well as its prognostic significance.


METHODS
This prospective study included a series of 60 patients with primary gastric adenocarcinoma, who first underwent a complete surgical resection of their tumors and then were evaluated for disease recurrence and survival status during a mean follow-up period of 41.5 months. Cath D was measured in cytosolic samples using an immune-radiometric assay which determined the total amount of Cath-D (52K, 48K, and 34K).


RESULTS
The tumor content of Cath-D ranged from 4 to 247 pmol/mg protein and from 6.4 to 97.7 pmol/mg protein in adjacent non-neoplastic mucosa samples. Cytosolic Cath-D levels were significantly higher in neoplastic tissues (P < 0.001). Statistical analysis also demonstrated that younger patients showed lower Cath-D tumor levels than older ones. Likewise, patients with lower tumor levels of Cath-D had better survival than those with intermediate or high Cath-D tumor content (P = 0.002). This finding showed an independent prognostic value on survival (P = 0.02).


CONCLUSIONS
The present study demonstrates the presence of higher Cath-D content in gastric carcinomas than in adjacent non-neoplastic mucosa, and that high intratumor Cath-D levels identify a subgroup of resectable gastric cancer patients with a high probability of relapse as well as worse survival.
Manuel Del Casar
José
J
Department of Surgery, Hospital de Jove, Gijón, Spain.
Vizoso
Francisco José
FJ
Abdel-Laa
Omar
O
Sanz
Lourdes
L
Martín
Aranzazu
A
Daniela Corte
María
M
Bongera
Miguel
M
García Muñiz
José Luis
JL
Fueyo
Antonio
A
D000230:Adenocarcinoma / Q000737:chemistry* / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002402:Cathepsin D / Q000032:analysis*; D003600:Cytosol / Q000737:chemistry; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000737:chemistry* / Q000473:pathology / Q000601:surgery; D016019:Survival Analysis
D002402:Cathepsin D