title: Clinicopathological correlation and prognostic significance of sonic hedgehog protein overexpression in human gastric cancer.
abstract: OBJECTIVE
  This study investigated the expression of Sonic Hedgehog (Shh) protein in gastric cancer, and correlated it with clinicopathological parameters. The prognostic significance of Shh protein was analyzed.
  
  
  METHODS
  Shh protein expression was evaluated in 113 cases of gastric cancer and 60 cases of normal gastric mucosa. The immunoreactivity was scored semi quantitatively as: 0 = absent; 1 = weak; 2 = moderate; and 3 = strong. All cases were further classified into two groups, namely non-overexpression group with score 0 or 1, and overexpression group with score 2 or 3. The overexpression of Shh protein was correlated with clinicopathological parameters. Survival analysis was then performed to determine the Shh protein prognostic significance in gastric cancer.
  
  
  RESULTS
  In immunohistochemistry study, nineteen (31.7%) normal gastric mucosa revealed Shh protein overexpression, while eighty-one (71.7%) gastric cancer revealed overexpression. The expression of Shh protein were significantly higher in gastric cancer tissues than in normal gastric mucosa (P < 0.001), which was statistically correlated with age (P = 0.006), tumor differentiation (P < 0.001), depth of invasion (P = 0.042), pathologic staging (P = 0.017), and nodal metastasis (P = 0.019). We found no significant difference in both overall and disease free survival rates between Shh overexpression and non-expression groups P = 0.168 and 0.071). However, Shh overexpression emerged as a significant independent prognostic factor in multivariate Cox regression analysis (hazard ratio 1.187, P = 0.041).
  
  
  CONCLUSIONS
  Shh protein expression is upregulated and is statistically correlated with age, tumor differentiation, depth of invasion, pathologic staging, and nodal metastasis. The Shh protein overexpression is a significant independent prognostic factor in multivariate Cox regression analysis in gastric cancer.
authors.affiliation: General Surgery Center of People's Liberation Army, Military General Surgery Center, Southwest Hospital, The Third Military Medical University Gaotanyan Street, Shapingba District, Chongqing 400038, People's Republic of China.
authors.forename: Yanyang
authors.initials: Y
authors.lastname: Niu
authors.affiliation: Department of Stomatology, Southwest Hospital, The Third Military Medical University Gaotanyan Street, Shapingba District, Chongqing 400038, People's Republic of China.
authors.forename: Fang
authors.initials: F
authors.lastname: Li
authors.affiliation: General Surgery Center of People's Liberation Army, Military General Surgery Center, Southwest Hospital, The Third Military Medical University Gaotanyan Street, Shapingba District, Chongqing 400038, People's Republic of China.
authors.forename: Bo
authors.initials: B
authors.lastname: Tang
authors.affiliation: General Surgery Center of People's Liberation Army, Military General Surgery Center, Southwest Hospital, The Third Military Medical University Gaotanyan Street, Shapingba District, Chongqing 400038, People's Republic of China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Shi
authors.affiliation: General Surgery Center of People's Liberation Army, Military General Surgery Center, Southwest Hospital, The Third Military Medical University Gaotanyan Street, Shapingba District, Chongqing 400038, People's Republic of China.
authors.forename: Yingxue
authors.initials: Y
authors.lastname: Hao
authors.affiliation: General Surgery Center of People's Liberation Army, Military General Surgery Center, Southwest Hospital, The Third Military Medical University Gaotanyan Street, Shapingba District, Chongqing 400038, People's Republic of China.
authors.forename: Peiwu
authors.initials: P
authors.lastname: Yu
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D018572:Disease-Free Survival; D005260:Female; D053823:Hedgehog Proteins / Q000032:analysis / Q000096:biosynthesis*; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D013274:Stomach Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D015854:Up-Regulation; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D053823:Hedgehog Proteins; C509239:SHH protein, human
keywords: Sonic hedgehog; gastric cancer; pathology; prognosis