title: Expression of a novel matrix metalloproteinase regulator, RECK, and its clinical significance in resected non-small cell lung cancer.
abstract: The reversion-inducing-cysteine-rich protein with Kazal motifs (RECK) was initially isolated as a transformation-suppressor gene by expression cloning and found to encode a membrane-anchored regulator of the matrix metalloproteinases (MMPs). Experimental studies have shown that RECK can suppress tumour - invasion, metastasis and angiogenesis. However, the clinical impact of RECK remains unclear. To assess the clinical significance of RECK-expression in non-small cell lung cancer (NSCLC), a total of 171 patients with completely resected pathological stage (p-stage) I-IIIA NSCLC were retrospectively examined. Expression of RECK and vascular endothelial growth factor (VEGF) in tumour tissues was assessed by immunohistochemical staining (IHS). Intratumoural microvessel density (IMVD), a measurement of angiogenesis, was also determined by IHS using an anti-CD34 antibody. A significant inverse correlation between RECK-expression and tumour angiogenesis was documented; the mean IMVD in tumours with strong RECK-expression (157.1) was significantly lower than that observed in tumours with weak RECK-expression (194.5; P = 0.008). Interestingly, this inverse correlation was seen only when VEGF was strongly expressed, which suggests that RECK could suppress the angiogenesis induced by VEGF. The 5-year survival rate for patients with tumours with strong RECK-expression (75.8%) was significantly higher than that for patients with weakly expressing tumours (54.3%; P = 0.016). Subset analyses showed that the prognostic impact of RECK-status was evident in patients with either adenocarcinoma, poorly differentiated tumours, or p-stage IIIA disease. A multivariate analysis confirmed that reduced RECK-expression was an independent and significant factor in predicting a poor prognosis (P = 0.009; Hazard ratio (HR), 0.474 with a 95% Confidence interval (CI) of 0.271-0.830). In conclusion, RECK-status is a significant prognostic factor correlated with tumour angiogenesis in NSCLC patients.
authors.affiliation: Department of Thoracic Surgery, Faculty of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Takenaka
authors.forename: Shinya
authors.initials: S
authors.lastname: Ishikawa
authors.forename: Yozo
authors.initials: Y
authors.lastname: Kawano
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yanagihara
authors.forename: Ryo
authors.initials: R
authors.lastname: Miyahara
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Otake
authors.forename: Yoko
authors.initials: Y
authors.lastname: Morioka
authors.forename: Chiaki
authors.initials: C
authors.lastname: Takahashi
authors.forename: Makoto
authors.initials: M
authors.lastname: Noda
authors.forename: Hiromi
authors.initials: H
authors.lastname: Wada
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Tanaka
mesh_terms: D017209:Apoptosis; D002289:Carcinoma, Non-Small-Cell Lung / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D002455:Cell Division; D005260:Female; D058851:GPI-Linked Proteins; D006801:Humans; D008175:Lung Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D008297:Male; D008562:Membrane Glycoproteins / Q000378:metabolism*; D008875:Middle Aged; D015999:Multivariate Analysis; D011184:Postoperative Period; D011379:Prognosis; D016019:Survival Analysis; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
chemical_list: D058851:GPI-Linked Proteins; D008562:Membrane Glycoproteins; C115460:RECK protein, human; D042461:Vascular Endothelial Growth Factor A