Expression Of GDF-5 In Gastric Cancer And Its Correlation With Clinicopathological Features

Objective: This study is to investigate the expression of growth differentiation factor-5(GDF-5)in gastric cancer and to anal yze the relationship between the expression of GDF-5 and clinicopathological parameters,further anal yze the relationship of GDF-5 and clinicopathological parameters with patient prognosis.To provide theoretical and clinica l support for the research of new anticancer drugs aimed GDF-5.Methods: The clinicopathological and survival data of 210 patients wh o underwent gastric cancer radical resection in the affiliated Hospital of Qingdao Universit y from January 2013 to January 2015 were collected in the form of outpatient clinic,medica l history and follow-up.The expression of GDF-5 in gastric cancer and paracancerous tissues was detected b y immunohistochemical experiment,and the correlation between its expression and clinicopathological parameters and its effect on prognosis were anal yzed.Results: the results of immunohistochemical showed that the expression of GDF-5 in paracancerous tissues was higher than in cancer tissues,the difference was statisticall y significant(t =14.689,P<0.001).According to the results of immunohistochem ical,86(41%)of the total 210 patients were assigned in the GDF-5 positive group and 124(59%)assigned in the negative group.The correlation between the expression of GDF-5 and clinicopathological parameters was analyzed by X~2 test.The positive expression rate of GDF-5 in tumor diameter <50mm group(47.5%)was higher than that in ≥50mm group(32.2%).The expression of GDF-5 was correlated with gastric cancer tumor diameter,and the difference was statisticall y significant(X~2=4.964,P=0.026).The positive expression rate of GDF-5 in patients with T1/T2 stage(55.1%)was higher than that in T3/T4 stage(36.6%).The expression of GDF-5 was correlated with the depth of cancer invasion,and the difference was statisticall y significant(X~2=5.292,P=0.021).The positive expression rate of GDF-5 in patients with microvascular invasion(47.1%)was higher than that in patients without microvascular invasion(33.0%).The expression of GDF-5 was associated with microvascular invasion in gastric cancer,and the difference was statistically significant(X~2=4.235,P=0.04).The positive expression rate of GDF-5 in the moderatel y-well differentiated group(51.5%)was higher than that in the non-poorl y differentiated group(36.1%).The expression of GDF-5 was related to the degree of differentiation of gastric cancer,and the difference was statisticall y significant(X~2=4.441,P=0.035).Patients age(X~2=1.270),sex(X~2=2.681),l ymph node meta stasis(X~2=1.664),nerve invasion(X~2=1.590)was no significant correlation between GDF-5 positive expression rate(P>0.05).Univariate survival anal ysis showed that tumor size,depth of invasion,l ymph node invasion,nerve invasion,degree of differentiation,GDF-5 expression level were significantly correlated with gastric cancer patients survival.The results of Cox multi variate regression analysis showed that GDF-5 expression level,tumor size,lymph node metastasis,nerve invasion and were all independent prognostic factors for the overall survival rate of gastric cancer patients.The clinicopathological parameters were divided into subgroups to anal yze the relationship between the GDF-5 expression in different subgroups and the survival time of gastric cancer patients.The results showed that the expression of GDF-5 was correlation with survival in patients of T3/T4 stage(P=0.029),male patients(P=0.016),l ymph node metasta sis(P=0.009),nerve invasion(P<0.001),microvascular invasion(P=0.044),age ≥65 years(P=0.031)and poorl y differentiated group(P=0.001),but no correlation was observed in other subgroups.Conclusion: the expression of GDF-5 in gastric cancer tissue is lower than normal tissues.The expression of GDF-5 is closel y related to tumor size,microvascular invasion,tumor invasion depth and differentiation degree.GDF-5 is an independent risk factor for the survival time of gastric cancer patients after radical resection.The low expression of GDF-5 indicates a poor prognosis in gastric cancer patients after radical resection.