title: High expression of C-C chemokine receptor 2 associates with poor overall survival in gastric cancer patients after surgical resection.
abstract: BACKGROUND
  Being a critical chemokine receptor in chemoattracting myeloid cells into tumor tissues, C-C chemokine receptor 2 (CCR2) has been detected in many malignant tumors. This study aims to evaluate the prognostic value of CCR2 expression in patients with gastric cancer after surgery.
  
  
  RESULTS
  CCR2 expression was detected in the accessory cells around gastric cancer cells in a diffused manner. CCR2 high expression was correlated with tumor invasion depth (P=0.006 and P=0.004, respectively), lymph node metastasis (P=0.038 and P=0.011, respectively) and TNM stage (P=0.003 and P=0.001, respectively) in the two independent sets. Multivariate Cox regression analysis identifies CCR2 high expression was an independent poor prognostic factor for OS of patients with gastric cancer in the two sets (P=0.013 and P=0.006, respectively). Integration of CCR2 expression and TNM stage could provide additional prognostic value for OS than TNM stage alone in the two sets (P=0.038 and P=0.002, respectively).
  
  
  METHODS
  Two independent sets comprising a total of 474 patients who received standard gastrectomy were enrolled in the study. The expression level of CCR2 was detected by immunohistochemistry. The correlations between CCR2 expression and clinicopathological factors were explored, and the prognostic significance for overall survival (OS) was determined by Kaplan-Meier analysis.
  
  
  CONCLUSIONS
  CCR2 high expression in the tumor microenvironment is a novel independent unfavorable prognostic factor for patients with gastric cancer. Combination of CCR2 expression and TNM stage could provide a better prognostic model for OS of gastric cancer patients.
authors.affiliation: Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China.
authors.forename: Ruochen
authors.initials: R
authors.lastname: Li
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Heng
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Lin
authors.affiliation: Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China.
authors.forename: Yifan
authors.initials: Y
authors.lastname: Cao
authors.affiliation: Department of Immunology, School of Basic Medical Sciences, Fudan University, Shanghai, China.
authors.forename: Weijuan
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Zhenbin
authors.initials: Z
authors.lastname: Shen
authors.affiliation: Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China.
authors.forename: Jiejie
authors.initials: J
authors.lastname: Xu
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D054390:Receptors, CCR2 / Q000378:metabolism*; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000556:secondary; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; C515334:CCR2 protein, human; D054390:Receptors, CCR2
keywords: CCR2; biomarker; gastric cancer; overall survival; prognosis