title: Loss of sympathetic nerve fibers around intratumoral arterioles reflects malignant potential of gastric cancer.
abstract: BACKGROUND
  The role and clinical significance of the alteration of sympathetic nerve fibers (SNF) was assessed in gastric cancer. Loss of nerve fibers in malignant tumors has previously been described; however, how dysfunction of the nervous system is involved in cancer progression has not been clarified in clinical studies.
  
  
  METHODS
  The distribution of SNF was examined in 82 surgically resected gastric cancer specimens with immunohistochemical staining of tyrosine hydroxylase (TH), and the association with clinicopathological findings as well as the clinical outcome of the patients was retrospectively evaluated.
  
  
  RESULTS
  Arterioles in the normal gastric wall were totally covered with SNF, while the immunoreactivity to TH was markedly reduced around arterioles in cancer tissue. The degree of loss of SNF was significantly correlated with the depth of invasion (P < .0001) and lymph node metastasis (P < .0001) as well as microvessel density (MVD) (P = .0043). Moreover, patients who had tumors with marked loss of SNF showed a markedly worse clinical outcome, with an independent association by multivariate analysis.
  
  
  CONCLUSIONS
  Loss of periarteriolar SNF is associated with aggressive phenotype of gastric cancer possibly through enhanced angiogenesis and thus could be a useful marker to predict the clinical outcome.
authors.affiliation: Department of Surgery, Division of Surgical Oncology, University of Tokyo, Tokyo, Japan. hmiya-tky@umin.ac.jp
authors.forename: Hideyo
authors.initials: H
authors.lastname: Miyato
authors.forename: Joji
authors.initials: J
authors.lastname: Kitayama
authors.forename: Hironori
authors.initials: H
authors.lastname: Ishigami
authors.forename: Shoichi
authors.initials: S
authors.lastname: Kaisaki
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Nagawa
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary* / Q000601:surgery; D000320:Adrenergic Fibers / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001160:Arterioles / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D007124:Immunoenzyme Techniques; D008207:Lymphatic Metastasis; D008297:Male; D055806:Microvessels / Q000473:pathology; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate; D013564:Sympathetic Nervous System / Q000473:pathology*; D014446:Tyrosine 3-Monooxygenase / Q000378:metabolism
chemical_list: D014446:Tyrosine 3-Monooxygenase