Expression of podocalyxin-like protein is an independent prognostic biomarker in resected esophageal and gastric adenocarcinoma.
Expression of podocalyxin-like protein is an independent prognostic biomarker in resected esophageal and gastric adenocarcinoma.
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DOI：
10.1186/s12907-016-0034-8
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发表时间：
2016
影响因子：
--
通讯作者：
Jirström K
中科院分区：
文献类型：
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作者：
Borg D;Hedner C;Nodin B;Larsson A;Johnsson A;Eberhard J;Jirström K
足糖萼蛋白样蛋白（PODXL）是一种细胞表面跨膜糖蛋白，其表达与一系列恶性肿瘤的预后不良相关。本研究的目的是研究PODXL表达对食管腺癌和胃腺癌生存率的影响。该研究队列由174例食管（包括胃食管交界处）或胃腺癌患者组成，这些患者在2006年至2010年期间接受手术治疗，未接受新辅助治疗。PODXL的免疫组化表达在组织芯片中进行了评估，芯片的核心来自原发性肿瘤、淋巴结转移、肠上皮化生和邻近的正常上皮。对无远处转移和无肉眼可见残留肿瘤的患者进行生存分析。在大多数情况下，与正常上皮细胞相比，PODXL在癌细胞中的表达显著更高，并且与淋巴结转移和高级别肿瘤显著相关。在食管腺癌中，Kaplan-Meier分析显示，与PODXL阳性肿瘤患者相比，PODXL阴性肿瘤患者的上级复发时间（TTR）和总生存期（OS）更优。在胃腺癌中，PODXL阴性肿瘤患者具有上级TTR和改善OS的趋势。在食管和胃腺癌组合中，PODXL表达对TTR的预后意义在未校正的考克斯回归分析中得到证实（HR = 5.36，95% CI 1.68-17.06，p = 0.005），并在校正模型中保持显著性（HR = 3.39，95% CI 1.01-11.35，p = 0.048）。此外，PODXL表达对OS的影响也在未校正的分析中得到证实（HR = 2.52，95% CI 1.31-4.85，p = 0.006），在校正的模型中仍然显著（HR = 2.03，95% CI 1.04-3.98，p = 0.039）。在食管和胃腺癌中，PODXL表达是减少复发时间和总生存率差的独立预后生物标志物。这是第一份关于PODXL在食管腺癌中的预后作用的报告，并验证了最近在胃癌中的发现。本文的在线版本（doi：10.1186/s12907-016-0034-8）包含补充材料，可供授权用户使用。
Podocalyxin-like protein (PODXL) is a cell surface transmembrane glycoprotein, the expression of which has been associated with poor prognosis in a range of malignancies. The aim of this study was to investigate the impact of PODXL expression on survival in esophageal and gastric adenocarcinoma. The study cohort consists of a consecutive series of 174 patients with esophageal (including the gastroesophageal junction) or gastric adenocarcinoma, surgically treated between 2006 and 2010 and not subjected to neoadjuvant treatment. Immunohistochemical expression of PODXL was assessed in tissue microarrays with cores from primary tumors, lymph node metastases, intestinal metaplasia and adjacent normal epithelium. Survival analyses were performed on patients with no distant metastases and no macroscopic residual tumor. In the majority of cases, expression of PODXL was significantly higher in cancer cells compared to normal epithelial cells and was significantly associated with lymph node metastases and high grade tumors. In esophageal adenocarcinoma, Kaplan-Meier analyses revealed that patients with PODXL negative tumors had a superior time to recurrence (TTR) and overall survival (OS) compared to patients with PODXL positive tumors. In gastric adenocarcinoma, patients with PODXL negative tumors had a superior TTR and a trend towards an improved OS. In esophageal and gastric adenocarcinoma combined, the prognostic significance of PODXL expression on TTR was confirmed in unadjusted Cox regression analysis (HR = 5.36, 95 % CI 1.68-17.06, p = 0.005) and remained significant in the adjusted model (HR = 3.39, 95 % CI 1.01-11.35, p = 0.048). Moreover, the impact of PODXL expression on OS was also confirmed in unadjusted analysis (HR = 2.52, 95 % CI 1.31-4.85, p = 0.006) and remained significant in the adjusted model (HR = 2.03, 95 % CI 1.04-3.98, p = 0.039). In esophageal and gastric adenocarcinoma, PODXL expression is an independent prognostic biomarker for reduced time to recurrence and poor overall survival. This is the first report on the prognostic role of PODXL in esophageal adenocarcinoma and validates recent findings in gastric cancer. The online version of this article (doi:10.1186/s12907-016-0034-8) contains supplementary material, which is available to authorized users.