Prospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 28, 2017; 23(20): 3721-3729
Published online May 28, 2017. doi: 10.3748/wjg.v23.i20.3721
Clinical significance of expression of proliferating cell nuclear antigen and E-cadherin in gastric carcinoma
Lin Hu, Hong-Lang Li, Wei-Feng Li, Jun-Min Chen, Jian-Tao Yang, Jun-Jing Gu, Lin Xin
Lin Hu, Hong-Lang Li, Wei-Feng Li, Jun-Min Chen, Jian-Tao Yang, Jun-Jing Gu, Lin Xin, Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
Author contributions: Hu L and Li HL designed the research, performed the research, and wrote the paper; Hu L, Li HL, Li WF, Chen JM, Yang JT, Gu JJ and Xin L contributed new reagents or analytic tools; Hu L, Li HL, Li WF, Chen JM and Yang JT analyzed the data; all authors approved the final version of the manuscript.
Supported by the National Natural Science Foundation of China, No. 81360330.
Institutional review board statement: The study was reviewed and approved by the Second Affiliated Hospital of Nanchang University Institutional Review Board.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent to study enrollment.
Conflict-of-interest statement: we declare that there are no conflicts of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hong-lang Li, MD, Chief physician, Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, East Lake District, Nanchang 330006, Jiangxi Province, China. lihonglang6802@163.com
Telephone: +86-791-86312170 Fax: +86-791-86312170
Received: February 16, 2017
Peer-review started: February 16, 2017
First decision: March 14, 2017
Revised: March 27, 2017
Accepted: May 4, 2017
Article in press: May 4, 2017
Published online: May 28, 2017
Processing time: 100 Days and 8.1 Hours
Abstract
AIM

to investigate the expression of proliferating cell nuclear antigen (PCNA) and E-cadherin in gastric carcinoma and to analyze their clinical significance.

METHODS

A total of 146 patients were selected for this study, including 38 patients with intestinal metaplasia, 42 with dysplasia, and 66 with primary gastric cancer. In addition, 40 patients with normal gastric tissues were selected as controls. The expression of PCNA and E-cadherin was detected by immunohistochemistry. Differences in PCNA and the E-cadherin labeling indexes among normal gastric mucosa, intestinal metaplasia, dysplasia, and gastric carcinoma were compared. Subjects with normal gastric tissues were assigned to a normal group, while gastric cancer patients were assigned to a gastric cancer group. The difference in PCNA and E-cadherin expression between these two groups was compared. The relationship between expression of PCNA and E-cadherin and clinicopathological features was also explored in gastric cancer patients. Furthermore, prognosis-related factors, as well as the expression of PCNA and E-cadherin, were analyzed in patients with gastric cancer to determine the 3-year survival of these patients.

RESULTS

The difference in PCNA and the E-cadherin labeling indexes among normal gastric mucosa, intestinal metaplasia, dysplasia, and gastric carcinoma was statistically significant (P < 0.05). During the transition of normal gastric mucosa to gastric cancer, the PCNA labeling index gradually increased, while the E-cadherin labeling index gradually decreased (P < 0.05). The PCNA labeling index was significantly higher and the E-cadherin labeling index was significantly lower in gastric cancer than in dysplasia (P < 0.05). The expression of PCNA was significantly higher in the gastric cancer group than in the normal group, but E-cadherin was weaker (P < 0.05). There was a negative correlation between the expression of PCNA and E-cadherin in gastric carcinoma (r = -0.741, P = 0.000). PCNA expression differed significantly between gastric cancer patients with and without lymph node metastasis and between patients at different T stages. E-cadherin expression also differed significantly between gastric cancer patients with and without lymph node metastasis (P < 0.05). High T stage and positive PCNA expression were risk factors for the prognosis of patients with gastric cancer (RR > 1), while the positive expression of E-cadherin was a protective factor (RR < 1). The sensitivity, specificity, and accuracy of PCNA positivity in predicting the 3-year survival of patients with gastric cancer were 93.33%, 38.89%, and 0.64, respectively; while these values for E-cadherin negativity were 80.0%, 41.67%, and 0.59, respectively. When PCNA positivity and E-cadherin negativity were combined, the sensitivity, specificity, and accuracy were 66.67%, 66.67%, and 0.67, respectively.

CONCLUSION

Combined detection of PCNA and E-cadherin can improve the accuracy of assessing the prognosis of patients with gastric cancer.

Keywords: proliferating cell nuclear antigen; E-cadherin; Gastric cancer; Gastric mucosa

Core tip: The expression of proliferating cell nuclear antigen (PCNA) and E-cadherin was detected by immunohistochemistry in gastric tissues of 186 patients. During the transition of normal gastric mucosa to gastric cancer, the PCNA labeling index gradually increased, while the E-cadherin labeling index gradually decreased (P < 0.05). There was a negative correlation between the expression of PCNA and E-cadherin in gastric carcinoma. High T stage and positive PCNA expression were risk factors for the prognosis of patients with gastric cancer (RR > 1), while the positive expression of E-cadherin was a protective factor (RR < 1). Combined detection of PCNA and E-cadherin can improve the accuracy of assessing the prognosis of patients with gastric cancer.