Abstract
Objective To investigate the association of serum soluble E-cadherin (sEC) expression before and after chemotherapy with the effects and prognosis in gastric cancer patients treated by FOLFOX4 regimen. Methods Chemotherapy was performed on 42 patients with gastric cancer using three cycles of FOLFOX4 regimen, tumor response adverse effects were observed, and survival was also followed up. E-cadherin was downregulated by small RNA interference in gastric cancer SGC-7901 cells. Enzyme linked immunosorbent assay (ELISA) was used to determine the sEC expression levels in cell culture supernatant and serum of gastric cancer patients before chemotherapy and at 8th week. Comparative analysis was performed for the serum expression of sEC before and after chemotherapy with clinical pathological features, short-term effects, progression free survival (PFS) and overall survival (OS) respectively. Statistical analyses were done using the SPSS 17.0 package, with χ2 test for count data, t test for measurement data, and Kaplan-Meier method for survival analysis. All tests of statistical significance were two-sided and P<0.05 was considered as statistically significant difference. Results Mean serum levels of sEC expression did not show significant difference before chemotherapy compared to those at 8th week after chemotherapy [(2.269±0.655) vs. (2.231±0.638) mg/ml]. Changes in sEC levels before and after chemotherapy in patients were significantly correlated with tumor stage, short-term effect, PFS and OS. Serum sEC expression levels in effective groups decreased significantly after chemotherapy as compared with those before chemotherapy [(2.617±0.711) vs. (1.949±0.458) mg/ml, P<0.01, t=5.790], and those increased significantly in progressive group after chemotherapy [(1.963±0.408) vs. (2.612±0.779) mg/ml, P<0.01, t=-3.665). Higher serum sEC expression before chemotherapy was significantly correlated with short-term effect, PFS and OS. Downregulation of E-cadherin by RNA interference could inhibit sEC expression which could be induced by 5-Fu in cell culture supernatant of SGC-7901 cells. Conclusion Serum sEC may be an independent predictor for effect and prognosis in gastric patients treated by FOLFOX4 regimen. Key words: Gastric cancer; Soluble E-cadherin; Chemotherapy; Prognosis
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