title: Increased expression of C-C motif ligand 2 associates with poor prognosis in patients with gastric cancer after gastrectomy.
abstract: Previous studies have demonstrated the clinical significance of polarized tumor-associated macrophages (TAMs) in gastric cancer whereas the cytokines orchestrating TAM polarization remain elusive. This study aims to evaluate the prognostic value of C-C motif ligand 2 (CCL2) expression in gastric cancer patients after surgery. We examined CCL2 expression in tumor tissues by immunohistochemical staining in retrospectively enrolled 414 gastric cancer patients receiving gastrectomy at Zhongshan Hospital during 2008. We used Kaplan-Meier analysis and Cox regression models to assess the prognostic value of CCL2 expression. We generated a predictive nomogram from integrating CCL2 expression with the TNM staging system to evaluate 3- and 5-year overall survival. High intratumor CCL2 expression associated with adverse clinical outcome. Intratumor CCL2 expression provided additional prognostic value in gastric cancer patients. CCL2 expression, as well as well-established TNM staging parameters, was identified as independent prognostic factor for overall survival. The generated nomogram corresponded well with the ideal model in predicting the 3- and 5-year overall survival of gastric cancer patients. CCL2, an identified potential independent adverse prognosticator, could be integrated with TNM staging system to improve the predictive accuracy for overall survival in gastric cancer patients especially with advanced stages.
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Feng Lin Road, Shanghai, 200032, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Feng Lin Road, Shanghai, 200032, China.
authors.forename: Zhenbin
authors.initials: Z
authors.lastname: Shen
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Feng Lin Road, Shanghai, 200032, China.
authors.forename: Xuefei
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Feng Lin Road, Shanghai, 200032, China.
authors.forename: Heng
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Feng Lin Road, Shanghai, 200032, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Qin
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Feng Lin Road, Shanghai, 200032, China.
authors.forename: Xinyu
authors.initials: X
authors.lastname: Qin
authors.affiliation: Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, China. jjxufdu@fudan.edu.cn.
authors.forename: Jiejie
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Feng Lin Road, Shanghai, 200032, China. sun.yihong@zs-hospital.sh.cn.
authors.forename: Yihong
authors.initials: Y
authors.lastname: Sun
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018932:Chemokine CCL2 / Q000096:biosynthesis*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000601:surgery*
chemical_list: C111835:CCL2 protein, human; D018932:Chemokine CCL2
keywords: Biomarker; CCL2; Gastric cancer; Nomogram; Overall survival; Prognosis