Clinicopathologic characteristics and survival outcomes of patients with advanced esophageal, gastroesophageal junction, and gastric adenocarcinoma: a single-institution experience

Predictive Value of Stemness Factor Sox2 in Gastric Cancer Is Associated with Tumor Location and Stage

Cancer stem cells (CSCs) are thought to be the "root" of cancer. Although stemness-related factors ALDH1A1 and Sox2 have been used as markers to identify gastric CSCs, the expression pattern and significance of these factors in gastric cancer have not been sufficiently demonstrated. In this study, the expressions of ALDH1A1 and Sox2 were detected by immunohistochemistry in 122 gastric cancer specimens. And the correlation between Sox2 or ALDH1A1 expression and clinicopathological parameters and overall survival data were analyzed. The positive rate of ALDH1A1 expression was 60%, but there was no significant difference between survival rates of ALDH1A1-positive and ALDH1A1-negative patients. Sox2 was expressed in 42% of specimens and was associated with poor prognosis of patients (P = 0.015). Stratified analysis showed that Sox2 expression correlated with shorter lifespan only in patients with cardiac gastric cancers (P = 0.002) or stage I or II gastric cancers (P = 0.002); but not in patients with non-cardiac cancers (P = 0.556) or stage III or IV gastric cancers (P = 0.121). Analysis on a database cohort validated the correlation between Sox2 expression and poor prognosis in stage II cancer. Also, expression of Sox2 was associated with lymphnode metastasis in patients with cardiac gastric cancer (P = 0.037). A multivariate analysis revealed that Sox2 was an independent prognostic factor in cardiac gastric cancer. Our results indicate that predictive value of Sox2 in gastric cancer is associated with cardiac cancer location and with early cancer stages (I and II).

UCH-LI acts as a novel prognostic biomarker in gastric cardiac adenocarcinoma

Gastric cardiac adenocarcinoma (GCA) accounts for a majority of gastric cancer population and harbors unfavorable outcome. Ubiquitin C-terminal hydrolase L1 (UCH-L1) belongs to the deubiquitinating enzyme family, which could regulate cell growth in human cancers. In the present study, expression of UCH-L1 was evaluated in 196 GCAs by immunohistochemistry using tissue microarray and its function on gastric cancer cells was measured. UCH-L1 expression was increased in GCA specimens, compared with their normal tissues and UCH-L1 overexpression is tightly correlated with tumor size and overall TNM stage. Log-rank analysis showed that UCH-L1 positive is reversely associated with cumulative survival (P<0.001). Multivariate Cox regression model showed that UCH-L1 overexpression is a remarkably negative predictor in GCA prognosis (Hazard Ratio=0.53, P<0.01), along with advanced TNM stage that is a known negative factor in gastric cancers (Hazard Ratio=0.33, P<0.05). Silencing of UCH-L1 reduced the ability of cell proliferation, colony formation, migration and invasion of gastric cancer cells. Our findings suggest that UCH-L1 is a promising prognostic biomarker for GCAs and might play an important role in the carcinogenesis of gastric cancer.

Demographic and histological predictors of survival in patients with gastric and esophageal carcinoma

BACKGROUND

Little is known about the possible influence of demographic and histological risk factors on the survival of patients with esophageal and gastric cancer.

OBJECTIVES

Based on the available registry and follow-up information, this study compares 1-5 year survival rate of gastric and esophageal cancer.

PATIENTS AND METHODS

Through a concurrent (prospective) cohort study, all 366 patients with definite diagnosis of esophageal and gastric cancer who had been hospitalized at the Towhid Hospital, Sanandaj city, Kurdistan province, western Iran during a five-year period from 2006 onwards were recruited. The survival time of patients stratified by this grouping method were analyzed by Kaplan-Meier analysis and Cox regression.

RESULTS

Amongst the 366 patients, 23 had esophageal adenocarcinoma, 94 esophageal squamous-cell carcinoma and 239 had gastric adenocarcinoma. Age at diagnosis (P = < 0.001), tumor grade (P = 0.008) and practice treatment (P = < 0.001) had significant associations with the variation of survival rates in patients with esophageal but not with gastric cancer. The five-year survival rates (by year) for esophageal cancer were 49%, 27%, 24%, 22% and 19%, respectively and for gastric cancer were 41%, 17%, 13%, 10% and 5.4%, respectively.

CONCLUSIONS

Major differences between these cancers were seen in the survival rates of patients and their incidence classified by sex. Age at diagnosis and histological types were prognostic factors for survival of patients with esophageal cancer but this wasn't the case for gastric cancer.