Clinical implications of DLL4 expression in gastric cancer

BACKGROUND: Delta-like ligand 4 (DLL4)-Notch signaling plays a key role in tumor neovascular development and angiogenesis during tumor growth. The clinical significance of DLL4 expression in gastric cancer has not been clarified. METHODS: Gastric cancer cell lines and 180 gastric cancer patients were enrolled. DLL4 expression in gastric cancer cells and stroma was identified and evaluated immunohistochemically. The association between DLL4 and clinicopathological factors was also assessed. RESULTS: DLL4 expression was identified in the cellular membrane and cytoplasm of gastric cancer cells by immunoblotting and immunohistochemical staining. DLL4 positivity in cancer cells and stroma was found in 88 (48%) and 41 (22%) of the 180 gastric cancer patients respectively. Both cancer and stromal DLL4 expression significantly correlated with more advanced tumor depth, nodal involvement, and lymphatic and venous invasion. A strongly positive association between cancerous and stromal DLL4 expression was identified (p < 0.01). Both cancerous and stromal DLL4 expression were prognostic markers in gastric cancer as determined by univariate analysis. CONCLUSIONS: Cancerous and stromal DLL4 expression was found in 48% and 22% in gastric cancer, and significantly affected postoperative clinical outcomes. Cancerous and stromal DLL4 expression may be an effective target of anti-DLL4 treatment in gastric cancer

Prognostic impact of CD168 expression in gastric cancer

<p>Abstract</p> <p>Background</p> <p>Interactions of stromal hyaluronic acid (HA) with its binding protein RHAMM (receptor for HA-mediated motility) (CD168) have been reported to affect tumor extension and the migration of crucial molecules to promote tumor progression and metastases. Cancerous CD168 expression is correlated with aggressive biological features in several cancers. However, the clinical implications of CD168 positivity in gastric cancer have remained unclear.</p> <p>Methods</p> <p>We examined the CD168 expression of 196 consecutive gastric cancer patients by immunohistochemistry. According to CD168 positivity, the 196 gastric cancer patients were divided into two groups (57 CD168-positive and 139 CD168-negative patients). The correlation between CD168 expression and clinicopathological factors (age, sex, histology, tumor depth, lymph node status, and vessel invasion) was evaluated according to the Japanese Classification of Gastric Carcinoma.</p> <p>Results</p> <p>Cancerous CD168 expression was detectable in 57 of the 196 tumors (29%). CD168 positivity was significantly correlated with the depth of invasion, nodal involvement, and vessel invasion (p < 0.01). Survival analysis of the 196 gastric cancer patients showed that the CD168-positive group had a significantly higher mortality than the CD168-negative group (p < 0.01). In terms of a correlation with CD168 positivity at separate clinical stages, a significance difference was only found in stages II and III. Multivariate analysis revealed that CD168 expression was a significant independent prognostic marker (p = 0.013) after depth of invasion (p < 0.005) and nodal involvement (p < 0.01).</p> <p>Conclusion</p> <p>Our results suggest that cancerous CD168 positivity is strongly related to the invasion and metastasis of gastric cancer tumors. These results suggest that cancerous CD168 expression can be used as a prognostic marker of gastric cancer owing to its interactions with stromal hyaluronic acid.</p

The 2G allele of promoter region of Matrix metalloproteinase-1 as an essential pre-condition for the early onset of oral squamous cell carcinoma

<p>Abstract</p> <p>Background</p> <p>Matrix metalloproteinase (<it>MMP</it>) is known to be involved in the initial and progressive stages of cancer development, and in the aggressive phenotypes of cancer. This study examines the association of single nucleotide polymorphisms in promoter regions of <it>MMP-1 </it>and <it>MMP-3 </it>with susceptibility to oral squamous cell carcinoma (OSCC).</p> <p>Methods</p> <p>We compared 170 Japanese OSCC cases and 164 healthy controls for genotypes of <it>MMP-1 </it>and <it>MMP-3</it>.</p> <p>Results</p> <p>The frequency of the <it>MMP-1 </it>2G allele was higher and that of the 1G homozygote was lower in the OSCC cases (<it>p </it>= 0.034). A multivariate logistic regression analysis revealed that subjects who were 45 years old or older had a significantly increased (2.47-fold) risk of OSCC (95%CI 1.47–4.14, <it>p </it>= 0.0006), and those carrying the <it>MMP-1 </it>2G allele had a 2.30-fold risk (95%CI 1.15–4.58, <it>p </it>= 0.018), indicating independent involvement of these factors in OSCC. One of the key discoveries of this research is the apparent reduction of the <it>MMP-1 </it>1G/1G and 1G/2G genotype distributions among the early onset OSCC cases under the ages of 45 years. It should be noted that the tongue was the primary site in 86.2% of these early onset cases. This could suggest the specific carcinogenic mechanisms, i.e. specific carcinogenic stimulations and/or genetic factors in the tongue.</p> <p>Conclusion</p> <p>Since the 2G allele is a majority of the <it>MMP-1 </it>genotype in the general population, it seems to act as a genetic pre-condition in OSCC development. However this report suggests a crucial impact of the <it>MMP-1 </it>2G allele in the early onset OSCC.</p

Novel case of laparoscopically resected gastric adenocarcinoma concurrent with lanthanum deposition

Abstract A 73‐year‐old man taking lanthanum carbonate for hemodialysis showed progressing gastric mucosal changes with lanthanum deposition. Regular examination revealed concurrent gastric carcinoma. The extent and depth of its invasion were ambiguous because of the surrounding lanthanum deposition. Furthermore, there could be other potent carcinomas, and curative laparoscopic gastrectomy was performed

Assessment of Percutaneous Laparoscopic Ultrasonography-Guided Core Needle Biopsy for the Advanced Diagnosis of Unresectable Pancreatic Cancer

Context Before the initiation of cytotoxic therapy for locally unresectable pancreatic cancer, staging laparoscopy is an important diagnostic method for both the detection of occult small lesions and the extraction of a tumor sample for advanced pathological examination using core needle biopsy (CNB) under laparoscopic ultrasonography (LUS) guidance. Objective This study aimed to evaluate the safety and usefulness of LUS-guided CNB in pancreatic cancer. Methods Consecutive patients with locally unresectable pancreatic cancer who underwent staging laparoscopy were retrospectively analyzed. LUS-guided CNB was performed percutaneously under a laparoscopic view. The clinical results of the LUS-guided CNB group and the non-LUS-guided CNB group were compared. Results Forty-eight patients who underwent staging laparoscopy by LUS-guided CNB or endoscopic ultrasound-guided fine needle aspiration were identified. LUS-guided CNB was performed in 25 patients. The mean tumor size in the LUS-guided CNB group was significantly larger than that in the non-LUS-guided CNB group. No significant difference was observed between the two groups in operating time or bleeding volume. The rates of malignancy diagnosis and histological classification subtyping were significantly higher in the LUS-guided CNB group. Histologically differentiated adenocarcinoma was identified in 15 patients using samples acquired by LUS-guided CNB. There was no uncontrollable bleeding or other complications, and a significant difference in the occurrence of peritoneal dissemination after laparoscopic examination was observed between the two groups. Conclusion LUS-guided CNB enables the safe acquisition of sufficient tissue volumes for certain pathological analyses required to determine treatment strategies for locally unresectable advanced pancreatic cancer

Role of miR-30a-3p Regulation of Oncogenic Targets in Pancreatic Ductal Adenocarcinoma Pathogenesis

Our recent studies have implicated some passenger strands of miRNAs in the molecular pathogenesis of human cancers. Analysis of the microRNA (miRNA) expression signature in pancreatic ductal adenocarcinoma (PDAC) has shown that levels of miR-30a-3p, the passenger strand derived from pre-mir-30a, are significantly downregulated in PDAC tissues. This study aimed to identify the oncogenes closely involved in PDAC molecular pathogenesis under the regulation of miR-30a-3p. Ectopic expression assays showed that miR-30a-3p expression inhibited the aggressiveness of the PDAC cells, suggesting that miR-30a-3p acts as a tumor-suppressive miRNA in PDAC cells. We further identified 102 putative targets of miR-30a-3p regulation in PDAC cells by combining in silico analysis with gene expression data. Of these, ten genes (EPS8, HMGA2, ENDOD1, SLC39A10, TGM2, MGLL, SERPINE1, ITGA2, DTL, and UACA) were independent prognostic factors in multivariate analysis of survival of patients with PDAC (p &lt; 0.01). We also investigated the oncogenic function of the integrin ITGA2 in PDAC cell lines. The integrin family comprises cell adhesion molecules expressed as heterodimeric, transmembrane proteins on the surface of various cells. Overexpression of ITGA2/ITGB1 (an ITGA2 binding partner) was detected in the PDAC clinical specimens. The knockdown of ITGA2 expression attenuated the malignant phenotypes of the PDAC cells. Together, results from these microRNA-based approaches can accelerate our understanding of PDAC molecular pathogenesis