The Study On Correlation Of Pepsinogen Expression With Clinicopathlogical Features And Prognosis In Gastric Cancer

Objective:To detect the expression of pepsinogen C(PGC)and the concentrations of serum pepsinogen A and C(SPGA SPGC),an aspartic proteinase involved in the digestion of proteins in the stomach,in patients with gastric cancer,and evaluate the correlation between the PGC expression and serum concentrations,and analyze the clinicopathological significance,and investigate the PGC expression and the prognosis of gastric carcinoma(GC),and determine the effect of clinicopathological features,PG to prognosis of GC.Methods:Tumor tissue and tissue in surgical margin of 30 cases(07～08)of gastric cancer with complete clinicopathological records were harvested;the blood samples were also collected in the morning after an overnight fast.The specimens were stained with immunohistochemistry method to determine the expression of PGC. Pepsinogen was labeled with anti-pepsinogen monoclonal antibody,the serum pepsinogen was detected with enzyme-linked-immunoabsorbent assay(ELISA).The correlation among the expression of PGC in tissue,the concentrations of SPGA,SPGC and the clinicopathological features was analyzed;70 cases(01～05)of gastric cancer were followed up,3 were missed.The specimens for these cases were stained with Immunohistochemistry method to detect PGC expression.Results:2(6.7%)gastric carcinomas stained positively for pepsinogen C.All surgical margin tissue was positive for PGC.The percentage of pepsinogen C-positive tumors was higher in well-differentiated than in moderately differentiated and poorly differentiated tumors(P＜0.05).Similarly,significant differences of pepsinogen C immunostaining were found between node-negative and node-positive tumors (P＜0.05).There was no significant difference of SPGC,SPGA,SPGA/C between the positive group and the negative group.Statistical analysis revealed that pepsinogen C expression was associated with clinical outcome in gastric cancer patients;There were 10 cases(14.9%)which carcinoma producing PGC in total 67 cases,Low PGC levels predicted short overall survival periods in the overall group of patients with gastric cancer(P＜0.05).Multivariate analysis according to Cox's model indicated that TNM staging and PGC expression were independent predictors of outcome for gastric cancer patients(P＜0.05).Conclusions:There was significant correlation of expression of PGC with clinicopathological features,but there was no significant correlation between the PGC expression and SPGA,SPGC,SPGA/C,which indicated that the concentration of SPG could not reflect the expression of PGC in tissue.Decreasing PGC during tumor growth and metastasis led an unfavorable prognosis.There was significant correlation between PGC expression with prognosis.The PGC expression was independent risk factor for prognosis,which could be used in prognosis evaluation and clinical treatment for patients with GC to improve survival.