title: AGR2 is associated with gastric cancer progression and poor survival.
abstract: Anterior gradient protein 2 (AGR2) has been reported as a novel biomarker with a potential oncogenic role. However, its association with the prognosis and survival rate of gastric cancer (GC) has not yet been determined. Therefore, the present study aimed to examine the expression and prognostic significance of AGR2 in patients with GC. Immunohistochemistry was used to analyze AGR2 and cathepsin D (CTSD) protein expression in 436 clinicopathologically characterized GC cases and 92 noncancerous tissue samples. AGR2 and CTSD expression were both elevated in GC lesions compared with noncancerous tissues. In 204/436 (46.8%) GC patients, high expression of AGR2 was positively correlated with the expression of CTSD (r=0.577, P<0.01). Furthermore, several clinicopathological parameters were significantly associated with AGR2 expression level, including tumor size, depth of invasion and TNM stage (P<0.05). Using Kaplan-Meier survival analysis, it was determined that the mean survival time of patients with low levels of AGR2 expression was significantly longer than those with high ARG2 expression (in stages I, II and III; P<0.05). For stage IV disease, no significant difference in survival time was identified. Multivariate survival analysis demonstrated that AGR2 was an independent prognostic factor and was associated in the progression of GC. The findings of the present study indicate that AGR2 expression is significantly associated with location and size of GC, depth of invasion, TNM stage, lymphatic metastasis, vessel invasion, distant metastasis, Lauren's classification, high CTSD expression and poor prognosis. Thus, AGR2 may be a novel GC marker and may present a potential therapeutic target for GC.
authors.affiliation: Department of Orthopaedics, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang 310014, P.R. China.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedics, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang 310014, P.R. China.
authors.forename: Yongming
authors.initials: Y
authors.lastname: Jin
authors.affiliation: Department of Orthopaedics, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang 310014, P.R. China.
authors.forename: Shaonan
authors.initials: S
authors.lastname: Xu
authors.affiliation: Department of Probability and Statistics, School of Mathematical Sciences, Peking University, Beijing 100871, P.R. China.
authors.forename: Jiayin
authors.initials: J
authors.lastname: Zheng
authors.affiliation: Department of Surgery, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang 310014, P.R. China.
authors.forename: Q I
authors.initials: QI
authors.lastname: Zhang
authors.affiliation: Department of Surgery, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang 310014, P.R. China.
authors.forename: Yuanyu
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Orthopaedics, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang 310014, P.R. China.
authors.forename: Jinping
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Orthopaedics, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang 310014, P.R. China.
authors.forename: Yazeng
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Key Laboratory of Gastroenterology of Zhejiang, Hangzhou, Zhejiang 310014, P.R. China.
authors.forename: Xujun
authors.initials: X
authors.lastname: He
authors.affiliation: Department of Pathology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang 310014, P.R. China.
authors.forename: Zhongsheng
authors.initials: Z
authors.lastname: Zhao
keywords: anterior gradient protein 2; cathepsin D; gastric cancer; immunohistochemistry; poor survival; progression