title: Patient survival by Hsp70 membrane phenotype: association with different routes of metastasis.
abstract: BACKGROUND
  Heat shock proteins (HSPs) play important roles in tumor immunity. The authors prospectively investigated the correlation between the tumor-specific Hsp70 membrane expression as an independent clinicopathological marker and overall survival in tumor entities that differ in their route of metastasis.
  
  
  METHODS
  Hsp70 membrane expression was examined by flow cytometry in 58 colon, 19 gastric, 54 lower rectal carcinoma, and 19 squamous cell carcinoma specimens and the corresponding normal tissues at time of first diagnosis. Kaplan-Meier survival curves were analyzed to determine the relation of Hsp70 expression to the patients' prognosis.
  
  
  RESULTS
  An Hsp70 membrane-positive phenotype was found in 40% (colon), 37% (gastric), 43% (lower rectal), and 42% (squamous cell) of the analyzed tumor specimens. None of the corresponding normal tissues was found to be Hsp70 membrane-positive. In patients with colon (P = .032) and gastric (P = .045) carcinomas, an Hsp70 membrane expression correlated significantly with an improved overall survival; a negative association was seen in lower rectal (P = .085) and squamous cell carcinoma (P = .048).
  
  
  CONCLUSIONS
  The authors hypothesized that differing relations between surface expression of Hsp70 on tumor cells and clinical outcomes may reflect differences in the route of metastases. Colon and gastric carcinomas metastasize into the liver where hepatic natural killer cells may have the capacity to recognize and kill Hsp70 membrane-positive tumor cells and thus account for a better overall survival.
authors.affiliation: Department for Surgery, University Hospital Regensburg, Regensburg, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Pfister
authors.forename: Jürgen
authors.initials: J
authors.lastname: Radons
authors.forename: Raymonde
authors.initials: R
authors.lastname: Busch
authors.forename: James G
authors.initials: JG
authors.lastname: Tidball
authors.forename: Michael
authors.initials: M
authors.lastname: Pfeifer
authors.forename: Lutz
authors.initials: L
authors.lastname: Freitag
authors.forename: Horst-Jürgen
authors.initials: HJ
authors.lastname: Feldmann
authors.forename: Valeria
authors.initials: V
authors.lastname: Milani
authors.forename: Rolf
authors.initials: R
authors.lastname: Issels
authors.forename: Gabriele
authors.initials: G
authors.lastname: Multhoff
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000378:metabolism / Q000473:pathology; D002462:Cell Membrane / Q000378:metabolism*; D003110:Colonic Neoplasms / Q000378:metabolism / Q000473:pathology; D005260:Female; D005434:Flow Cytometry / Q000379:methods; D005500:Follow-Up Studies; D018840:HSP70 Heat-Shock Proteins / Q000032:analysis*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D009369:Neoplasms / Q000378:metabolism / Q000473:pathology*; D011379:Prognosis; D012004:Rectal Neoplasms / Q000378:metabolism / Q000473:pathology; D013274:Stomach Neoplasms / Q000378:metabolism / Q000473:pathology; D014407:Tumor Cells, Cultured
chemical_list: D018840:HSP70 Heat-Shock Proteins