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Epithelial and stromal syndecan-1 expression as predictor of outcome in patients with gastric cancer

2001; Wiley; Volume: 95; Issue: 1 Linguagem: Inglês

10.1002/1097-0215(20010120)95

1097-0215

Jan‐Patrik Wiksten, Johan Lundin, Stig Nordling, Mikael Lundin, Arto Kokkola, Kristina von Boguslawski, Caj Haglund,

Gastric Cancer Management and Outcomes

The prognostic value of the immunohistochemical expression of epithelial and stromal syndecan-1 was evaluated in 296 patients with gastric carcinoma. Formalin-fixed, paraffin-embedded specimens of gastric adenocarcinomas were stained with mouse monoclonal antibody B-B4 against human syndecan-1. Loss of immunoreactivity (≤60% of cancer cells stained) was observed in 197 (67%) patients. Stromal immunoreactivity was observed in 28 (9%) patients. Loss of epithelial syndecan-1 immunoreactivity correlated with a higher stage of disease (stages II–IV), tumour location in the upper third of the stomach, nodal metastases (N1 or N2), positive stromal syndecan-1 staining, deep tumour penetration (to subserosa or deeper = T2–T4), larger tumour size (≥5 cm) and intestinal type of cancer. No correlation between epithelial syndecan-1 immunoreactivity and age, gender, distant metastases, grade of differentiation or Borrmann classification was observed. Positive stromal syndecan-1 immunoreactivity correlated with decreased epithelial syndecan-1 expression, intestinal type of cancer and Borrmann type I. Patients with low epithelial syndecan-1 expression in cancer cells had worse overall survival than patients with strong epithelial syndecan-1 staining (p = 0.0012). Stromal syndecan-1-positive patients had a worse outcome than patients with syndecan-1-negative stroma (p = 0.0193). In Cox multivariate analysis, stromal syndecan-1 immunoreactivity was a prognostic factor independent of TNM stage, surgery for cure and tumour size. Thus, the immunohistochemical expression of syndecan-1 might be a predictor of outcome in patients with gastric adenocarcinoma. © 2001 Wiley-Liss, Inc.