title: Activation of FOXO3a suggests good prognosis of patients with radically resected gastric cancer.
abstract: OBJECTIVE
  This study sought to investigate the role of the forkhead transcription factor FOXO3a in the prognosis of stage II/III gastric cancer patients.
  
  
  METHODS
  A single-institution cohort of 289 patients with stage II/III gastric cancer was studied. Formalin-fixed paraffin-embedded tumor and adjacent normal specimens were used for tissue microarray construction. Tissue sections were immunostained with FOXO3a. Microscopic evaluation to assess the presence and localization of FOXO3a in tumor and adjacent normal tissues was performed. Results were analyzed for association with clinicopathological characters and overall survival (OS).
  
  
  RESULTS
  FOXO3a expression was significantly higher in tumor tissues compared with adjacent normal tissues, and nuclear FOXO3a staining was observed to be more common in tumor samples than adjacent normal tissues. Poorer prognosis was seen in patients with tumors harboring lower expression of FOXO3a and also patients with adjacent normal tissues harboring higher expression of FOXO3a. High expression of FOXO3a in tumor tissues served as a good prognostic marker with multivariate hazard ratio (HR) of 0.737 (95% CI, 0.574 to 0.947; P=0.017) for OS.
  
  
  CONCLUSIONS
  The expression of FOXO3a was upregulated and activated in gastric cancer tissues, and was significantly associated with a favorable prognosis in stage II/III gastric cancer patients.
authors.affiliation: Department of Medical Oncology, Zhongshan Hospital, Fudan University Shanghai, People's Republic of China.
authors.forename: Shan
authors.initials: S
authors.lastname: Yu
authors.affiliation: Department of Medical Oncology, Zhongshan Hospital, Fudan University Shanghai, People's Republic of China.
authors.forename: Yiyi
authors.initials: Y
authors.lastname: Yu
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University Shanghai, People's Republic of China.
authors.forename: Yihong
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University Shanghai, People's Republic of China.
authors.forename: Xuefei
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Pathology, Zhongshan Hospital, Fudan University Shanghai, People's Republic of China.
authors.forename: Rongkui
authors.initials: R
authors.lastname: Luo
authors.affiliation: Department of Biostatistics, Fudan University Shanghai, People's Republic of China.
authors.forename: Naiqing
authors.initials: N
authors.lastname: Zhao
authors.affiliation: Department of Medical Oncology, Zhongshan Hospital, Fudan University Shanghai, People's Republic of China.
authors.forename: Wen
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Medical Oncology, Zhongshan Hospital, Fudan University Shanghai, People's Republic of China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Medical Oncology, Zhongshan Hospital, Fudan University Shanghai, People's Republic of China.
authors.forename: Yuehong
authors.initials: Y
authors.lastname: Cui
authors.affiliation: Department of Medical Oncology, Zhongshan Hospital, Fudan University Shanghai, People's Republic of China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Medical Oncology, Zhongshan Hospital, Fudan University Shanghai, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Medical Oncology, Zhongshan Hospital, Fudan University Shanghai, People's Republic of China.
authors.forename: Tianshu
authors.initials: T
authors.lastname: Liu
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D005260:Female; D000071316:Forkhead Box Protein O3; D051858:Forkhead Transcription Factors / Q000032:analysis / Q000096:biosynthesis*; D005743:Gastrectomy; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D046888:Tissue Array Analysis
chemical_list: D014408:Biomarkers, Tumor; C499517:FOXO3 protein, human; D000071316:Forkhead Box Protein O3; D051858:Forkhead Transcription Factors
keywords: FOXO3a; gastric cancer; prognosis