Abstract
Gastric cancer is a common malignancy and remains one of the leading causes of cancer-related deaths, though its incidence is in decline in most developed countries. One of the major challenges of treating gastric cancer is tumor heterogeneity, which portends a high degree of prognostic variance and the necessity for different treatment modalities. Tumor heterogeneity is at least in part due to divergent differentiation of tumor cells to clones harboring different molecular alterations. Here we studied the expression of emerging prognostic markers SOX9, MCL-1, and SPOCK1 (Testican-1) in a cohort of gastric cancer by immunohistochemistry and investigated how individual biomarkers and their combinations predict disease prognosis. We found frequent expression of SPOCK1 (in both nuclei and cytoplasm), MCL-1 and SOX9 in gastric cancer. In univariate analysis, nuclear SPOCK1 expression and pathologic TNM stage were negative prognostic markers in this cohort. In multivariate analysis, SOX9 expression stood out as a predictor of poor prognosis. Further subgroup analysis suggested prognostic value of SOX9 expression in poorly differentiated gastric adenocarcinoma. MCL-1 showed no prognostic role in this cohort.
Highlights
Gastric cancer is the fifth most common malignancy in the world and remains the third highest cause of cancer-related mortality after lung and colorectal cancer [1]
Among 201 tumors scored for SOX9, 64 (31.8%) showed high expression, 62 (30.9%) showed moderate expression, and 75 (37.3%) showed low expression; Among 184 tumors scored for Myeloid leukemia cell differentiation protein 1 (MCL-1), 93 tumors (51%) showed high expression; Among 144 tumors scored for SPOCK1, 78 tumors (54%) showed high nuclear expression, 107 tumors
We found SOX9 was frequently expressed in gastric cancer
Summary
Gastric cancer is the fifth most common malignancy in the world and remains the third highest cause of cancer-related mortality after lung and colorectal cancer [1]. The outcomes of gastric cancer patients depend on tumor resectability [3]. The survival in patients after curative resection has improved from 14% in the 1980s to 49% in most recent series, forty to fifty percent of the gastric cancer patients recured [3,4]. Eighty percent of gastric cancer patients present with unresectable and metastatic disease [4]. We present a study on the expression of emerging biomarkers SOX9, MCL-1 and SPOCK1 in a gastric cancer tissue microarray (TMA). Their correlation with differentiation markers, expression of PD-L1 and HER2/neu and prognosis was explored
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
