title: SPARC is associated with gastric cancer progression and poor survival of patients.
abstract: OBJECTIVE
  The present study investigated the clinical significance of secreted protein, acidic and rich in cysteine (SPARC), in the development and progression of gastric cancer.
  
  
  METHODS
  Immunohistochemistry was used to analyze SPARC, integrin beta1, and matrix metalloproteinase (MMP)-2 expression in 436 clinicopathologically characterized gastric cancer cases.
  
  
  RESULTS
  SPARC, integrin beta1, and MMP-2 protein levels were upregulated in gastric cancer lesions compared with adjacent noncancerous tissues. SPARC protein was detected in 334 of 436 human gastric cancer cases and was highly expressed in 239 tumors. We also found a positive correlation between expression of SPARC and MMP2, and SPARC and integrin beta1. In stages I, II, and III, the 5-year survival rate of patients with a high expression of SPARC was significantly lower than those in patients with low expression. In stage IV, SPARC expression did not correlate with the 5-year survival rate. Further multivariate analysis suggested that the depth of invasion; lymph node and distant metastasis; tumor-node-metastasis stage; and upregulation of SPARC, MMP-2, and integrin beta1, were independent prognostic indicators for the disease.
  
  
  CONCLUSIONS
  Our study provided a basis for the development of a novel biomarker for diagnosis and prognosis of gastric cancer. Expression of SPARC in gastric cancer is significantly associated with lymph node and distant metastasis, high MMP2 expression, high intergrin beta1 expression, and poor prognosis. SPARC, intergrin beta1, and MMP-2 protein could be useful markers to predict tumor progression.
authors.affiliation: Departments of Pathology and Surgery, Zhejiang Provincal People's Hospital, Hangzhou, Zhejiang, People's Republic of China. lywyy1979@hotmail.com
authors.forename: Zhong-Sheng
authors.initials: ZS
authors.lastname: Zhao
authors.forename: Yuan-Yu
authors.initials: YY
authors.lastname: Wang
authors.forename: Yong-Quan
authors.initials: YQ
authors.lastname: Chu
authors.forename: Zai-Yuan
authors.initials: ZY
authors.lastname: Ye
authors.forename: Hou-Quan
authors.initials: HQ
authors.lastname: Tao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor; D018450:Disease Progression; D005260:Female; D005753:Gastric Mucosa / Q000378:metabolism; D006801:Humans; D019012:Integrin beta1 / Q000378:metabolism*; D008207:Lymphatic Metastasis; D008297:Male; D020778:Matrix Metalloproteinase 2 / Q000378:metabolism*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D015676:Osteonectin / Q000378:metabolism*; D011379:Prognosis; D013274:Stomach Neoplasms / Q000378:metabolism* / Q000401:mortality; D015854:Up-Regulation
chemical_list: D014408:Biomarkers, Tumor; D019012:Integrin beta1; D015676:Osteonectin; D020778:Matrix Metalloproteinase 2