title: High CD40 expression in gastric cancer associated with expanding type histology and liver metastasis.
abstract: OBJECTIVE
  We have previously reported higher serum TNF-alpha levels in some gastric cancer patients. The status of its receptor (CD40 expression) in gastric cancer tissue and their clinical relevance is worthy of study.
  
  
  METHODS
  The expression of CD40 was examined immunohistochemically in 32 gastric carcinoma specimens and graded as high and low expressions according to the proportion of stained tumor cells. The clinicopathological factors including age, sex, tumor location, size, gross appearance, stromal reaction pattern, degree of cellular differentiation, histological classification, depth of tumor invasion, lymph node status, peritoneal dissemination, liver metastasis and TNM stage were analyzed according to the different expression of CD40.
  
  
  RESULTS
  There were 18 patients with low CD40 expression and 14 patients with high CD40 expression. There were more expanding type tumors than infiltrating type by Ming's histological classification (57.1% vs. 16.7%, p=0.027) and liver metastasis (28.6% vs. 0, p=0.028) in the high expression group. The patient survival showed a worse tendency in patients with high CD40 expression, but did not reach statistical difference. There was no correlation between CD40 expression level and other clinicopathological features.
  
  
  CONCLUSIONS
  The fact that high CD40 expression existed more in expanding type tumor and had more liver metastasis suggests CD40 may play an important role in local invasion mode and hematogenous spread.
authors.affiliation: Department of Surgery, I-Lan Hospital, Taiwan. sslo@vghtpe.gov.tw
authors.forename: Su-Shun
authors.initials: SS
authors.lastname: Lo
authors.forename: Chew-Wun
authors.initials: CW
authors.lastname: Wu
authors.forename: Chin-Wen
authors.initials: CW
authors.lastname: Chi
authors.forename: Anna F Y
authors.initials: AF
authors.lastname: Li
authors.forename: Jen-Hao
authors.initials: JH
authors.lastname: Chen
authors.forename: Wing-Yiu
authors.initials: WY
authors.lastname: Lui
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D001707:Biopsy, Needle; D019013:CD40 Antigens / Q000235:genetics / Q000378:metabolism*; D018450:Disease Progression; D005260:Female; D005743:Gastrectomy / Q000379:methods; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000503:physiopathology / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009367:Neoplasm Staging; D011336:Probability; D011379:Prognosis; D018570:Risk Assessment; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis
chemical_list: D014408:Biomarkers, Tumor; D019013:CD40 Antigens