Abstract
Although appl1 is overexpressed in many cancers, its status in gastric cancer (gc) is not known. In the present study, we used relevant pathologic and clinical data to investigate appl1 expression in patients with gc. In 47 gc and 27 non-gc surgical specimens, immunohistochemistry was used to detect the expression of appl1, and reverse-transcriptase polymerase chain reaction (rt-pcr) was used to detect messenger rna (mrna). A scatterplot visualized the relationship between survival time and mrna expression in gc patients. The log-rank test and other survival statistics were used to determine the association of appl1 expression with the pathologic features of the cancer and clinical outcomes. In gc, appl1 was expressed in 28 of 47 specimens (59.6%), and in non-gc, it was expressed in 7 of 23 specimens (30.4%, p < 0.05). The expression of mrna in gc was 0.82 [95% confidence interval (ci): 0.78 to 0.86], and in non-gc, it was 0.73 (95% ci: 0.69 to 0.77; p < 0.05). Immunohistochemistry demonstrated that, in gc, appl1 expression was correlated with depth of infiltration (p = 0.005), lymph node metastasis (p = 0.017), and TNM stage (p = 0.022), but not with pathologic type (p = 0.41). Testing by rt-pcr demonstrated that, in gc, appl1 mrna expression was correlated with depth of infiltration (p = 0.042), lymph node metastasis (p = 0.031), and TNM stage (p = 0.04), but again, not with pathologic type (p = 0.98). The correlation coefficient between survival time and mrna expression was -0.83 (p < 0.01). Overexpression of appl1 protein (hazard ratio: 3.88; 95% ci: 1.07 to 14.09) and mrna (hazard ratio: 4.23; 95% ci: 3.09 to 15.11) was a risk factor for death in patients with gc. Expression of appl1 is increased in gc. Overexpression is prognostic for a lethal outcome.
Highlights
Gastric cancer is the second most common cancer worldwide[1]
Diagnosis is more likely to result in a successful surgical intervention than is a diagnosis made when metastasis is present[4,5]
After appl[1] mrna for gc and non-gc specimens was examined by rt-pcr, expression in gc specimens was 0.82 [95% confidence interval: 0.78 to 0.86], and expression in non-gc specimens was 0.73 (95% ci: 0.69 to 0.77; p < 0.01; Table ii, Figure 2)
Summary
Gastric cancer (gc) is the second most common cancer worldwide[1]. In many countries in Asia, China, gc is still a significant health issue even though its incidence has been decreasing annually since the mid1990s2. Diagnosis is more likely to result in a successful surgical intervention than is a diagnosis made when metastasis is present[4,5]. Early diagnosis presents difficulties[6] because the “key” molecule or molecules for gc have not been identified. Appl[1] is overexpressed in many cancers, its status in gastric cancer (gc) is not known. We used relevant pathologic and clinical data to investigate appl[1] expression in patients with gc
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