title: Prognostic value of cytosolyc cathepsin D content in resectable gastric cancer.
abstract: 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.
authors.affiliation: Department of Surgery, Hospital de Jove, Gijón, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Manuel Del Casar
authors.forename: Francisco José
authors.initials: FJ
authors.lastname: Vizoso
authors.forename: Omar
authors.initials: O
authors.lastname: Abdel-Laa
authors.forename: Lourdes
authors.initials: L
authors.lastname: Sanz
authors.forename: Aranzazu
authors.initials: A
authors.lastname: Martín
authors.forename: María
authors.initials: M
authors.lastname: Daniela Corte
authors.forename: Miguel
authors.initials: M
authors.lastname: Bongera
authors.forename: José Luis
authors.initials: JL
authors.lastname: García Muñiz
authors.forename: Antonio
authors.initials: A
authors.lastname: Fueyo
mesh_terms: 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
chemical_list: D002402:Cathepsin D