Expression Of ECM1in Gastric Cancer And Metastasis And Its Clinical Significance

Background:Extracellular matrix proteinl ECM1is a kind of secretory glycoprotein, extracted from MN7in mouse.The end of its amino is a signal peptide composed of nineteen amino acids stump. Studies found that ECM1could promote the reproduction of endothelial cells and the formation of vessels. It was reported that specific changes of ECM1expression have been discovered in human solid tumors. ECM1is combined with extracellular matrix by different domains, which plays a vital role in the transition of various tumor invasions, such as breast cancer, colorectal cancer, thyroid carcinoma, and hepatic cancer. Gastric cancer is one of the most common cancer types in China. The outcome for gastric cancer patients remains poor. Researchers have paid great attention to control the transition of gastric cancer. However, the mechanism of gastric cancer metastasis is still not clear. Investigation of the mechanism of gastric cancer occurrence, progression, metastasis and outcome would help us to find new strategy to effectively treat this malignancy.Methods:In this study, immunohistochemical staining was used to examine the expressions of ECMl in the paraneoplastic tissues, primary gastric cancer tissues, lymphatic metastasis and distant metastasis. Three hundred and fifty-four gastric cancer patients were admitted to Department of Surgical Oncology and General surgery in Taizhou Hospital from July2008to July2010, and302of them received surgical resection of gastric cancer. Fourty cases of them with complete pathological data were confirmed with lymphatic metastasis and distant metastasis. The immunohistochemical staining results were reviewed and evaluated. The expression levels of ECM1in paraneoplastic tissues, primary tumor, lymphatic metastasis and distant metastasis were analyzed with Chi-square test and Independent-sample t test using SPSS soft ware. Patient’s survival was analyzed with Kaplan-Meier analysis.Results:(1) The characteristics of the of ECM1expression:ECM1is expressed in cytoplasm, but not in nucleus.(2) Positive expression rate of ECM1in paraneoplastic tissues, primary tumor, lymphatic metastasis and distant metastasis are77.5%、7.5%、55.0%、82.5%, respectively. Paraneoplastic tissue compared with primary tumor, primary tumor compared with lymphatic metastasis are statistic significance(P<0.05).(3) There is no statistic significance of the expression level of ECM1in the primary tumor of gastric carcinoma among different subgroups of gross type, histological type, histological differential grade, invasion depth and stage of lymphatic metastasis.(4) There is no statistic significance of the expression level of ECM1△1in the primary tumor of gastric carcinoma among different subgroups of gross type, histological type, histological differential grade, invasion depth and stage of lymphatic metastasis.(5) There is no statistic significance of the expression level of ECM1△2in the primary tumor of gastric carcinoma among different subgroups of gross type, histological type, histological differential grade, invasion depth and stage of lymphatic metastasis.(6) There is no statistic significance of the expression level of ECM1△1on the overall survival of patients with gastric cancer.(7) There is statistic significance of the expression level of ECM1△1on the overall survival of patients with gastric cancer.(8) On the survival time using multiple regression assay, no relationship was found between ECM1△1and age, gender, tumor size, foci of histological type, tumor location, tumor differentiation, lymph node stage (P>0.05), however, ECM1△2was significantly associated with age, gender, tumor size, foci of histological type, tumor location, tumor differentiation, lymph node stage on the survival time (P<.05).Conclusions:ECMl differentially expressed in gastric primary tumor and lymph node metastases indicating ECM1might be associated with gastric cancer metastasis. ECM1A2was associated with gastric cancer patients’ prognosis and could be considered as an independent prognostic factor in gastric cancer indicating ECM1△2an important indicator in determining the prognosis of gastric cancer.