The Expressions And Clinical Significances Of Runx3 And Its Correlation Factors In Gastric Adenocarcinoma By Tissue Microarray

Objective To study the expressions of Runx3 and related factors(Smad4,Cdk2,p21)in human gastric adenocarcinoma and corresponding para-cancer gastric mucosa,and the relationship with clinical and pathological features of gastric adenocarcinoma. To initial explore the biological significances of Runx3,Smad4,Cdk2,p21 in the carcinogenesis and progression of the gastric adenocarcinoma. To evaluate the clinical prognostic value of the expressions of Runx3 ,Smad4,Cdk2,p21 to the gastric adenocarcinoma.Mehtods 132 cases of gastric adenocarcinoma,248 cases of para-cancer mucosa paraffin embedded blocks were accumulated and four tissue microarrays which containing 174 dots, 282 dots, 156 dots and 156 dots were made. The expressions of Runx3, Smad4, p21 and Cdk2 were detected by immunohistochemical method to these tissue microarrays. Survival rates were calculated by Kaplan-Meier method,and the comparison of survival curve were accomplished by Log-rank test , univariate and multivariate analysis using Cox proportional hazards model. Statistical analysis was completed by SPSS16.0 statistic software.Results The efficiently rate of our tissue microarrays was 98.5%. In gastric adenocarcinoma, the rate of abnormal Runx3, Smad4, Cdk2 and p21 staining was 67.7%(88/130), 35.4%(46/130), 63.8%(83/130), 70.0%(91/130) respectively. the rate of abnormal Runx3, Smad4, Cdk2 and p21 in para-cancer gastric mucosa was 14.1%(35/248), 12.5%(31/248),18.1%(45/248),37.1%(92/248) respectively.Significant differences of the expressions were found among gastric adenocarcinoma and corresponding para-cancer gastric mucosa (P<0.05). No correlations of expressions of Runx3 with clinicopathological parameters but histological grade and lymph node metastasis were found (P<0.05). Expressions of Smad4 and p21 were closely relatd to the histological grade (P<0.05). and Cdk2 expression was closely relatd to histological grade, lymph node metastasis and TNM stage. The positive correlation between the aberrant expression of Runx3 and the abnormal expression of Smad4, p21 were found.(P < 0.05). There were significant negative correlation between runx3 and Cdk2 (P<0.05), and positive correlation between Smad4 and p21(P<0.05), Kaplan-Meier analysis showed that the 3-year survival rate of Runx3, Smad4, p21, Cdk2 normal expression group was significantly higher than in abnormal expression group respectively(P<0.05). Furthermore, multivariate analysis indicated that Runx3 and Smad4 expression were independent prognostic factors of gastric cancer patients(P<0.05).Conclusions The aberrant expression of Runx3 is closely related to the metastasis and invasion activity of the gastric adenocarcinoma. The Runx3 and related factors (Smad4, p21, Cdk2)may play a pivotal role in the carcinogenesis and progression of gastric adenocarcinoma . Runx3 and Smad4 may be judged as the objective index to evaluating the prognosis of patients with gastric adenocarcinoma.