Prognostic Significance of DNA Ploidy, S-Phase Fraction, and Tissue Levels of Aspartic, Cysteine, and Serine Proteases in Operable Gastric Carcinoma
2000
A
consecutive series of 63 untreated patients undergoing surgical
resection for stage I-IV gastric adenocarcinomas (GCs) has been
prospectively studied. Our purpose was to analyze the predictive
relevance of DNA ploidy, S-phase fraction (SPF), and tissue levels of
lysosomal proteinases cathepsin D (CD), cathepsin B (CB), cathepsin L
(CL), and urokinase-type plasminogen activator (uPA) and that of the
intracellular cysteine proteinase inhibitor stefin A on clinical
outcome. All of the patients taking part in this study were followed up
for a median of 73 months. DNA aneuploidy was present in 71% of the
cases (45/63), whereas 9% of these (4/45) showed multiclonality. Both
DNA ploidy and SPF were associated with tumor-node-metastasis (TNM)
stage and node status, whereas only DNA ploidy was related to depth of
invasion. CB, CL, uPA, but not CD, levels were significantly higher in
GC as compared to paired normal mucosa, whereas stefin A levels were
lower in tumor tissues. CB levels were significantly associated with
TNM stage, nodal status, histological grade, and DNA ploidy. At
univariate analysis, only node involvement, advanced TNM stage, DNA
aneuploidy, and high SPF proved to be significantly related to quicker
relapse and to shorter overall survival, whereas depth of invasion was
related only to survival. With multivariate analysis, only high SPF
(>15.2%) was related to risk of relapse (RR = 8.50), whereas
high SPF and DNA aneuploidy were independently related to risk of death
(RR = 1.88 and 2.09, respectively). Our preliminary prospective
study has identified SPF and DNA ploidy as important biological
indicators for predicting the outcome of patients with GC.
Keywords:
- Correction
- Source
- Cite
- Save
- Machine Reading By IdeaReader
37
References
26
Citations
NaN
KQI