title: Clinicopathologic significance of cystatin C expression in gliomas.
abstract: Cathepsin B, one of the lysosomal cysteine proteases, has been related to tumor invasiveness. Cystatin C is the strongest inhibitor of cathepsin B. Knowledge of its participation in the progression of gliomas is limited. We investigated the expression of cystatin C and its association with the clinicopathologic features of 57 gliomas. Cystatin C and cathepsin B expressions were evaluated by immunohistochemical methods and by semiquantitative real-time polymerase chain reaction analysis for the corresponding messenger RNA. Disease-free survival was analyzed by the Kaplan-Meier method. Tumors with low cystatin C protein expression and high cathepsin B protein expression were significantly more likely to be of high grade, and this pattern was significantly correlated with high Ki-67 LI and tumor recurrence. Depressed expression of cystatin C messenger RNA in glioblastomas compared with low-grade astrocytomas was demonstrated. Multivariate analysis demonstrated high tumor grade, high Ki-67 labeling index, high cathepsin B expression, and low cystatin C expression correlated significantly with shorter disease-free survival. These results suggest that gliomas in patients with an unfavorable clinical outcome are characterized by depressed expression of cystatin C. Evaluation of cystatin C expression in gliomas provides useful clinical information, especially as a prognostic indicator.
authors.affiliation: Department of Neurosurgery, Kochi University Medical School, Kochi, Japan. nakarinh@med.kochi-u.ac.jp
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Nakabayashi
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Hara
authors.forename: Keiji
authors.initials: K
authors.lastname: Shimuzu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology; D002401:Cathepsin B / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D055316:Cystatin C; D015891:Cystatins / Q000378:metabolism*; D018572:Disease-Free Survival; D005260:Female; D005910:Glioma / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D016019:Survival Analysis
chemical_list: C525030:CST3 protein, human; D055316:Cystatin C; D015891:Cystatins; D002401:Cathepsin B