title: Prognostic value of sonic hedgehog protein expression in gastric cancer.
abstract: OBJECTIVE
  Sonic hedgehog is produced in gastric epithelial cells and plays a crucial role in parietal cell function and the regulation of gastric epithelial cell differentiation. Emerging evidence suggests that the sonic hedgehog pathway is not only involved in the development of cancers but also in their progression and aggressiveness.
  
  
  METHODS
  To assess its prognostic value in gastric cancer, sonic hedgehog protein expression was measured by immunohistochemistry in a clinically annotated tissue microarray comprising 319 human gastric cancer specimens. Cytoplasmic sonic hedgehog expression was scored from 0 to 4, reflecting the percentage of sonic hedgehog-positive cells.
  
  
  RESULTS
  Specimens were classified into two groups according to their sonic hedgehog score: those with a score ranging from 0 to 3 were considered low expressers and those with a score of 4 were considered overexpressers. The sonic hedgehog overexpression group included more patients with early gastric cancer than the low sonic hedgehog expression group (25.9 vs. 74.1%, P=0.000). Sonic hedgehog expression was lower in patients with lymph node metastasis than in patients without lymph node metastasis (31.4 vs. 68.4%, P=0.02). Similarly, patients with a lower TNM stage showed significantly higher sonic hedgehog expression. In addition, the survival time of patients with sonic hedgehog overexpression was significantly prolonged (69.27±1.39 months) compared with that of patients with low sonic hedgehog expression (61.23±2.04 months, log-rank test, P=0.03).
  
  
  CONCLUSIONS
  These results indicate that sonic hedgehog overexpression may be a marker of good prognosis in gastric cancer.
authors.affiliation: Department of Surgery, Gyeongnam Regional Cancer Center, Gyeongsang National University, 79 Gangnam-ro, Jinju, Gyeongsang South Province 660-702, Republic of Korea.
authors.forename: Ju-Yeon
authors.initials: JY
authors.lastname: Kim
authors.forename: Gyung Hyuck
authors.initials: GH
authors.lastname: Ko
authors.forename: Young-Joon
authors.initials: YJ
authors.lastname: Lee
authors.forename: Woo-Song
authors.initials: WS
authors.lastname: Ha
authors.forename: Sang-Kyung
authors.initials: SK
authors.lastname: Choi
authors.forename: Eun-Jung
authors.initials: EJ
authors.lastname: Jung
authors.forename: Chi-Young
authors.initials: CY
authors.lastname: Jeong
authors.forename: Young-Tae
authors.initials: YT
authors.lastname: Ju
authors.forename: Sang-Ho
authors.initials: SH
authors.lastname: Jeong
authors.forename: Soon-Chan
authors.initials: SC
authors.lastname: Hong
mesh_terms: D014408:Biomarkers, Tumor / Q000096:biosynthesis*; D053823:Hedgehog Proteins / Q000096:biosynthesis*; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000378:metabolism*; D046888:Tissue Array Analysis
chemical_list: D014408:Biomarkers, Tumor; D053823:Hedgehog Proteins; C509239:SHH protein, human