title: Prognostic significance of BRCA1 expression in gastric cancer.
abstract: The breast and ovarian cancer susceptibility gene 1 (BRCA1) is a well-known tumor suppressor gene implicated in the predisposition of early-onset breast and ovarian cancer. The aim of this study is to identify the prognostic significance of BRCA1 in patients with gastric cancer undergoing surgery and platinum-based adjuvant chemotherapy. BRCA1 protein expression profiles were evaluated by immunohistochemistry (IHC) on surgical specimens of 637 gastric cancer patients. The relationships between BRCA1 expression and existing prognostic factors, platinum-based adjuvant chemotherapy, disease-free survival, and overall survival were analyzed. There were 637 stage II/III patients, of which 219 samples (34 %) were evaluated as BRCA1 IHC positive. BRCA1 expression had statistically significant association only with tumor differentiation (p = 0.004). The patients with BRCA1-positive expression had significantly prolonged overall survival (p = 0.049). The patients received platinum-based adjuvant chemotherapy showed a better prognosis (p = 0.017). The patients with BRCA1-negative expression benefited more from platinum-based adjuvant chemotherapy (p = 0.024). Multivariate analysis demonstrated that tumor size, T category, N category, vascular or nerves invasion, and platinum-based adjuvant chemotherapy were good prognostic factors for overall survival (p < 0.05). BRCA1 expression was not significantly related to overall survival (p = 0.127). The positive correlation between BRCA1 expression and overall survival suggests that patients with BRCA1 expression have a better prognosis in gastric cancer. Patients without BRCA1 expression can benefit from platinum-based adjuvant chemotherapy. However, BRCA1 expression might not be a good prognostic factor.
authors.affiliation: Department of Medical Oncology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, Gulou District, Nanjing City 210029, China.
authors.forename: Wenjiao
authors.initials: W
authors.lastname: Chen
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.forename: Xiao
authors.initials: X
authors.lastname: Li
authors.forename: Jingying
authors.initials: J
authors.lastname: Li
authors.forename: Li
authors.initials: L
authors.lastname: Zhou
authors.forename: Tianzhu
authors.initials: T
authors.lastname: Qiu
authors.forename: Meiling
authors.initials: M
authors.lastname: Zhang
authors.forename: Ping
authors.initials: P
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D019313:BRCA1 Protein / Q000032:analysis / Q000096:biosynthesis*; D014408:Biomarkers, Tumor / Q000032:analysis*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017671:Platinum Compounds / Q000627:therapeutic use; D011379:Prognosis; D016016:Proportional Hazards Models; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000378:metabolism* / Q000401:mortality*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D019313:BRCA1 Protein; D014408:Biomarkers, Tumor; D017671:Platinum Compounds