| Objective: The expression of tumor gene, molecular and protein may change between and after chemotherapy. However, it’s unclear whether secreted protein, acidic and rich in cysteine(SPARC) expression alters after chemotherapy in gastric cancer. Further clarification of the status of SPARC phenotype under the intervention of chemotherapy will have clinical implications for the reasonable arrangement of chemotherapy, treatment decisions and prognosis for gastric cancer patients. Therefore, we investigated the influence of chemotherapy on SPARC expression in gastric cancer.Methods: 1. From January 2008 to December 2012, a totle of 132 clinicopathologically characterized gastric cancer cases in Tianjin Medical University Cancer Hospital were included in this study, among these 132 cases, 54 cases with preoperative chemotherapy then radical resection of gastric cancer and 78 cases without preoperative chemotherapy and undergoing radical resection of gastric cancer; we collected the gastric carcinoma and corresponding normal gastric mucosa paraffin blocks samples of two groups; 2. Immunohistochemistry was used to analyze SPARC expression in gastric cancer tissues and the corresponding normal gastric mucosa tissues; 3. We assessed the SPARC expression of postoperative specimens between with and without preoperative chemotherapy to analyze the influence of chemotherapy on SPARC expression, the relationship between SPARC expression and clinicopathological factors, the prognosis. These results were analyzed by SPSS17.0 software.Results: In gastric cancer tissues, SPARC was highly expressed in the gastric cancer cells, the positive SPARC expression was mainly located in the cytoplasm of gastric cancer cells; low expressed or negative in the desmoplastic stroma surrounding the tumor cells. SPARC was low expressed in the normal gastric mucosa tissue cells. The ratio of high SPARC expression in the gastric cancer cells was 70.5%(55/78), which was significantly higher than that in normal gastric mucosa tissues 29.2%(7/24)(P<0.01). High SPARC expression correlated with invasion depth, lymph node metastasis and TNM stage(P <0.05); did not significantly correlate with age, gender, tumor location, tumor size, gross type, histological type and histologic differentiation(P>0.05). After chemotherapy, there was a lower proportion of high SPARC expression in patients with preoperative chemotherapy than in controls without preoperative chemotherapy(P <0.05). For 54 gastric cancer patients with preoperative chemotherapy, gross type, histology, depth of invasion, lymph node metastasis, TNM stage and SPARC expression, were related to overall survival. Further multivariate analysis suggested that lymph node metastasis, histology and SPARC expression after chemotherapy were independent prognostic factors.Conclusions: In gastric cancer, SPARC was highly expressed in the gastric cancer cells, low expressed or negative in the desmoplastic stroma surrounding the tumor cells. SPARC was low expressed in the normal gastric mucosa tissue cells. The ratio of high SPARC expression in the gastric cancer cells was significantly higher than that in normal gastric mucosa tissue. High SPARC expression correlated with invasion depth, lymph node metastasis and TNM stage. In the whole of gastric cancer patients, there was no significant correlation between SPARC expression and 2 years prognosis; however, for gastric cancer patients with neoadjuvent chemotherapy, patients with high SPARC expression after neoadjuvent chemotherapy had a poor prognosis. After chemotherapy, there was a lower proportion of high SPARC expression in patients with preoperative chemotherapy than controls without preoperative chemotherapy, preoperative chemotherapy may lower the expression level of SPARC in gastric cancer patients. |
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