title: Significance of effector protease receptor-1 expression and its relationship with proliferation and apoptotic index in patients with primary advanced gastric adenocarcinoma.
abstract: OBJECTIVE
  To investigate the expression of effector protease receptor-1 (EPR-1), proliferative index ki-67 and apoptosis index in patients with primary advanced gastric adenocarcinoma and to clarify the significance of EPR-1 expression and its correlationship with the proliferation and apoptosis indexes.
  
  
  METHODS
  Using immunohistochemical staining and terminal deoxynucleotidyl transferase mediated nick end labelling (TUNEL) technique, we determined the expression of EPR-1, proliferative index (Ki-67) and apoptotic index (AI) in 120 paraffin-embedded specimens of primary advanced gastric adenocarcinoma as well as lymph node metastasis and adjacent normal tissues.
  
  
  RESULTS
  EPR-1 expression was distributed in the cytoplasm of normal gastric mycoderma, carcinoma cells and smooth muscle cells. The positive rate of EPR-1 expression in the primary gastric adenocarcinomas, invasion tumor node and lymph node metastasis was 65.83%, 55.29% and 68%, respectively. While the positive rate in normal gastric mycoderma and smooth muscle cells was 46.7% and 53.3%, respectively. The average positive rate of ki-67 in EPR-1-positive tumors was 7.00% which was significantly lower than that of 8.53% in EPR-1-negative tumors, but the average AI in EPR-1-positive tumors was 1.25%, which was significantly higher than that of 1.00% observed in EPR-1-negative tumors. On the other hand, the average positive labeling index for Ki-67 (ki-67) in EPR-1-positive lymph node metastasis was 7.65%, which was significantly lower than that of 9.44% observed in EPR-1-negative lymph node metastasis. However, the average AI in EPR-1-positive lymph node metastasis tumors was 0.99%, which was significantly higher than that of 0.67% observed in EPR-1-negative lymph node metastasis.
  
  
  CONCLUSIONS
  The frequency of EPR-1 expression was significantly higher in primary gastric adenocarcinoma and in its lymph node metastasis than that in normal gastric mucosa. Expression of EPR-1 was significantly correlated with tumor histological subtypes and tumor differentiation. Weighted EPR-1 Score is positively correlated with apoptosis index, but is negatively related with proliferative index. Thus, Weighted EPR-1 Score and EPR-1 expression in gastric adenocarcinoma cells maybe a potential marker in clinical setting.
authors.affiliation: School of Medicine, Nanjing University, Department of General Surgery, Jinling Hospital, 305 Zhongshangdong Road, Nanjing, 210002, Jingsu Province, China. yaoxuequan@yahoo.com
authors.forename: Xue-Quan
authors.initials: XQ
authors.lastname: Yao
authors.forename: Fu-Kun
authors.initials: FK
authors.lastname: Liu
authors.forename: Jie-Shou
authors.initials: JS
authors.lastname: Li
authors.forename: Xiao-Ping
authors.initials: XP
authors.lastname: Qi
authors.forename: Bo
authors.initials: B
authors.lastname: Wu
authors.forename: Hong-Lin
authors.initials: HL
authors.lastname: Yin
authors.forename: Heng-Hui
authors.initials: HH
authors.lastname: Ma
authors.forename: Qun-Li
authors.initials: QL
authors.lastname: Shi
authors.forename: Xiao-Jun
authors.initials: XJ
authors.lastname: Zhou
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism* / Q000473:pathology; D017209:Apoptosis / Q000502:physiology*; D002455:Cell Division / Q000502:physiology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D020287:In Situ Nick-End Labeling; D051034:Inhibitor of Apoptosis Proteins; D019394:Ki-67 Antigen / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011956:Receptors, Cell Surface / Q000235:genetics / Q000378:metabolism*; D013223:Statistics as Topic; D013274:Stomach Neoplasms / Q000378:metabolism* / Q000473:pathology; D000077022:Survivin
chemical_list: C107489:BIRC5 protein, human; D051034:Inhibitor of Apoptosis Proteins; D019394:Ki-67 Antigen; D011956:Receptors, Cell Surface; D000077022:Survivin