The Significance Of The Expression With Periostin And CD68in Elderly Proximal Gastric Cancer With Radiotherapy

Objective: The development of gastric cancer is related to the tumormicroenvironment. Periostin and TAM（TAM’s surface marker is CD68） isinterstitial cell specific protein and immune cell, they can secret variouscytokine to promote tumor growth, and destroy extracellular matrix topromote tumor metastasis and immune escape. The aim of this study was toexplore the protein expression of Periostin and CD68in elderly proximalgastric cancer by using immunohistochemical method, analysis therelationship between Periostin and TAM and clinical pathological features andprognosis of gastric cancer.Methods:160cases of proximal gastric cancer without operation, age≥65, KPS≥70,were collected from January2009to December2012, who were treated withchemoradiotherapy and Clinical dates were completed. All these patientsincluding36male and24female were diagnosed by endoscopic biopsy. Meanage was72.1±4.96years, medial age was71.5years. According to the TNMstage of UICC/AJCC2010, Including stage I:0cases, stage II:15cases, stageIII:40cases, stage IV:5cases (5cases with single liver metastasis).2To detected the expression of Periostin and CD68in tissues of gastriccancer by immunohistochemistry (SP method) and analyze the relationbetween Periostin and CD68expression with clinical-pathological parametersand prognosis of gastric cancer.3The data was analyzed using SPSS16.0. According statistical data ofDifferent respectively by means of Mean±Standard deviation, χ2test, Pearsoncorrelationanalysis and Kaplan-Meier survival analysis, P<0.05wasconsidered statistical difference.Results: 1Expression of Periostin in gastric cancerThe expression of Periostin was observed in tissue of elderly proximalgastric cancer, and it was mainly expressed in the cancer cells with cytoplasm.Brown yellow, dispersion distribution. The positive expression rate was71.7%(43/60).The results showed that the positive expression of Periostin wassignificantly correlated with the tumor size, lymph node metastasis and TNMstage, χ2test showed there was a significant differences (P<0.05). The resultsshowed that the positive expression rate of Periostin in tumor diameter <2cmand≥2cm group was30%(3/10) and80%(40/50), respectively; and41.2%(7/17) and83.7%(36/43) in no-lymph node metastasis group and lymphnode metastasis group, respectively. And22.2%(2/9) and80.4%(41/51) in I-IIstage and III-IV stage group, respectively. While there was no significancewith gender, tumor degree of differentiation and distant metastasis (P>0.05).2Expression of CD68in gastric cancerThe expression of CD68was observed in tissue of elderly proximalgastric cancer, and it was mainly expressed the cytoplasm in macrophageswith brown yellow, dispersion distribution, the positive expression rate was78.3%(47/60) and significantly correlated with the tumor size, lymph nodemetastasis, distant metastasis and TNM stage (P<0.05). The positiveexpression rate of CD68in tumor diameter <2cm and≥2cm group was40%(4/10) and86%(43/50), respectively; and43.2%(7/17) and93%(40/43) inno-lymph node metastasis group and lymph node metastasis group,respectively. and33.3%(3/9) and86.3%(44/51)in I-II stage group and III-IVstage group, respectively. While there was no significance with gender, tumordegree of differentiation and distant metastasis (P>0.05).3The relationship between the expression of Periostin and CD68The co-expression of Periostin and CD68was40cases in gastric cancer,There was a close correlation between the expression of Periostin and CD68inthe gastric cancer tissues (r=0.567, P=0.000).4The relationship between the expression of Periostin and CD68andradiotherapy effect 13cases CR and10cases PR in the positive expression of Periostin of43cases, total effective rate(CR+PR) was53.5%(23/43);9cases CR and6casesPR in negative expression of Periostin of17cases, total effective rate(CR+PR)was88.2%(15/17), respectively. The expression of Periostin was negativelycorrelated with radiation response rate(P<0.05).14cases CR and15cases PRin the positive expression of CD68of47cases, total effective rate(CR+PR)was61.7%(29/47);4cases CR and5cases PR in negative expression ofPeriostin of17cases, total effective rate(CR+PR) was69.2%(9/13)(P>0.05).The expression of CD68was not correlated with radiation responserate(P>0.05).The1-,2-and3-year survival rate of the patients with positive andnegative expression of Periostin was65.1%,41.9%,7.0%and88.2%,58.8%,29.4%, respectively; The1-,2-and3-year survival rate of the patients withpositive and negative expression of CD68was61.7%,44.7%,8.5%and92.3%,69.2%,30.8%, respectively, with Kaplan-Meier survival curve analysis, theexpression of Periostin and CD68was negatively correlated withsurvival(P<0.05).5The prognosis and influential factors analysis in elderly proximalgastric cancerAnalysis with one-way: Degree of differentiation, distance metastasis,TNM stage, Periostin, CD68was correlated with the prognosis of elderlyproximal gastric cancer(P＜0.05). But it wasn’t correlated with gender, age,tumor size and lymph node metastasis(P＞0.05).Analysis with Multi-way: Independent prognostic risk factor for gastriccancer was not found.Conclusion:1Both Periostin and CD68had high expression in gastric cancer tissues,and there was a close correlation between the expression of Periostin andCD68in gastric cancer tissues; the expression of Periostin and CD68wassignificantly correlated with the tumor size, lymph node metastasis and TNMstage, which was correlated with clinical stages. 2The remission rate of radiotherapy of positive expression of Periostinwas lower than negative; The remission rate of radiotherapy has no relationwith the expression of CD68. The1-,2-and3-year survival rate of positiveexpression of Periostin and CD68was lower than negative.3Degree of differentiation, distance metastasis, TNM stage, Periostin,CD68was correlated with the prognosis of elderly proximal gastric cancer.