title: Clinical significance of midkine expression in sporadic desmoid tumors.
abstract: The aim of the present study was to identify the prognostic factors for the propensity for recurrence in sporadic desmoid tumors. The catenin (cadherin-associated protein) β1 (CTNNB1)genotypes and expression of Wnt pathway proteins and midkine (also termed neurite growth-promoting factor 2) were investigated in 159 patients with sporadic desmoid tumors. Formalin-fixed paraffin-embedded tissues of the surgically resected desmoid tumors were examined by direct sequencing ofCTNNB1exon 3, and immunostained for the expression of β-catenin, T-cell factor 4 (TCF-4), phosphorylated protein kinase B (pAkt), midkine and menin using a tissue microarray method. Among the samples, 70% (111/159) exhibited point mutations of theCTNNB1gene, including T41A (56%), S45F (8%), S45P (2%), S45N (2%) and T42A (1%). In addition, 100, 57, 24, 15 and 92% of the tumors expressed β-catenin, TCF-4, midkine, pAkt and menin, respectively. Positive midkine expression was significantly associated with the recurrence of tumors (P=0.001). The multivariate analysis of recurrence demonstrated that an extra-abdominal tumor site [hazard ratio (HR), 2.625; P=0.001] and midkine expression (HR, 2.077; P<0.009) were independent prognostic factors of tumor recurrence. In conclusion, the present results suggest that the tumor site and midkine expression may be predictive markers for the recurrence of sporadic desmoid tumors.
authors.affiliation: Department of Pathology, College of Medicine, Chung-Ang University, Seoul 156-755, Republic of Korea.
authors.forename: Hee Sung
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Cancer Research Institute, College of Medicine, Seoul National University, Seoul 110-799, Republic of Korea.
authors.forename: Jin
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Pathology, Haeundae Paik Hospital, Inje University College of Medicine, Busan 612-896, Republic of Korea.
authors.forename: Kyung Han
authors.initials: KH
authors.lastname: Nam
authors.affiliation: Cancer Research Institute, College of Medicine, Seoul National University, Seoul 110-799, Republic of Korea; Department of Pathology, College of Medicine, Seoul National University, Seoul 110-799, Republic of Korea.
authors.forename: Woo Ho
authors.initials: WH
authors.lastname: Kim
keywords: CTNNB1; desmoid tumor; midkine; recurrence