title: Prognostic impact of tumoral and/or peri-tumoral stromal SPARC expressions after surgery in patients with biliary tract cancer.
abstract: OBJECTIVE
  SPARC (secreted protein acidic and rich in cysteine) is a matricellular glycoprotein that modulates interactions between tumoral cells and the peri-tumoralstroma. SPARC induces proliferation and invasion in vitro, and is a poor prognostic factor in several gastrointestinal cancers. Herein, we evaluated the prognostic value of tumoral and stromal SPARC expression in patients with biliary tract cancer (BTC) after surgery.
  
  
  METHODS
  We examined immunohistochemical patterns of SPARC expression in 110 resected BTC specimens and evaluated the prognostic value using prospectively collected data.
  
  
  RESULTS
  SPARC was expressed in tumoral cells in 46 samples (42%) and inperi-tumoralstromain 65 samples (59%). Tumoral SPARC expression was not related to major patient characteristics. Stromal SPARC expression was related to lymph node metastasis, stage, margin status, and tumor location. Overall survival at 5 years after surgery was 34.2%. Stromal SPARC (P < 0.001) and tumoral SPARC (P = 0.048) were associated with poor prognosis. Multivariate analysis revealed invasion into lymphatic system, residual tumor, and stromal SPARC as independent prognostic factors. The hazard ratio for patients with positive stromal SPARC was 3.20 (P < 0.001).
  
  
  CONCLUSIONS
  SPARC expression inperi-tumoralstroma predicts a poor prognosis for patients with BTC after surgery.
authors.affiliation: Department of Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Nakashima
authors.forename: Shogo
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Sakai
authors.forename: Akira
authors.initials: A
authors.lastname: Tomokuni
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Tomimaru
authors.forename: Naoki
authors.initials: N
authors.lastname: Hama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Wada
authors.forename: Koichi
authors.initials: K
authors.lastname: Kawamoto
authors.forename: Shigeru
authors.initials: S
authors.lastname: Marubashi
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Eguchi
authors.forename: Nariaki
authors.initials: N
authors.lastname: Matsuura
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Doki
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nagano
mesh_terms: D000328:Adult; D000368:Aged; D001661:Biliary Tract Neoplasms / Q000737:chemistry / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D015676:Osteonectin / Q000032:analysis*; D011379:Prognosis
chemical_list: D015676:Osteonectin; C577241:SPARC protein, human
keywords: SPARC; biliary tract cancer; osteonectin