The Expression Of Twist2,E-cadherin And CD13in Gastric Carcinoma:Relationship With The Infiltration, Metastasis And Prognosis Of Gastric Carcinoma

Objective:To evaluate the Twist2, E-cadherin and CD13expressions in gastric cancer and investigate their relationships with tumor infiltration, metastasis and prognosis of gastric carcinoma, as well the effection of Twist2expression to E-cadherin and tumor stem-cell markers CD13.Methods:We gathered specimens of gastric cancer in Maanshan, Anhui Province, Central Hospital cases of gastric cancer after surgical resection and be pathologically confirmed during2005to2011.After we followed-up in detail,we select104specimens as the experimental group. In104specimens,We used60cases (2005.1-2007.12) which have five-years follow-up datas as analysis about survival and prognosis. We select16specimens of normal gastric mucosa,which come from gastric ulcer patients with pathologically confirmed subtotal gastrectomy,as control.Immunohistochemical technique with SP method was used examine the expressions of Twist2, E-cadherin and CD13and their relationships with tumor infiltration, metastasis and prognosis.COX proportional regression model was used to define the prognostic factors that determine the survival of the patients.Results:1.In gastric tissue,the positive rates of Twist2, E-cadherin and CD13were77.9%(81/104),37.5%(39/104)and74%(77/104),respectively. Compared with the control group, the expression of Twist2and CD13in gastric carcinoma were significantly increased (P<0.01), the expression of E-cad in gastric carcinoma was significantly reduced (P<0.01). Spearman test showed that the expressions of Twist2correlated negatively with those of E-cadherin (r=-0.257, p<0.05), and showed that the expressions of CD13correlated negatively with those of E-cadherin (r=-0.266, p <0.05),also showed that the expressions of Twist2correlated positively with those of CD13(r=0.266, p<0.05).2. The x2test and Fisher’s exact test were used to analyze the relationships of Twist2, E-cadherin and CD13expressions with the clinicopathological parameters of gastric cancer. There were no significant differences between the expressions of CD13and age, sex, lymph node metastasis (P>0.05). The expressions of CD13were found to be correlative with tumor size, clinical stage, degree of differentiation(P<0.05). On the other hand, the expressions of Twist2and E-cad were found to be correlative with gastric depth of invasion, lymph node metastasis, clinical stage (P<0.05).3. By Log Rank analysis, there was no difference between Twist2expression and survival time(P>0.05). But the survival time in patients with negative expressions of CD13was longer than the positive group (P<0.05). The expressions of E-cad significantly correlated with depth of tumor invasion, lymph node metastasis, clinical stage were (p<0.01).4.By Cox regression model analysis, the results showed that the depth of invasion and degree of differentiation and the expression of CD13were found to be the independent factors for prognosis of gastric cancer patients (p<0.05).Conclusions:1.The expressions of Twist2and CD13are significant higher, as while the expressions of E-cadherin are significant lower in gastric cancer.The expressions of Twist2may reduce the expressions of E-cadherin and up-regulate the expressions of the cancer stem-cell marker CD13.2.The expressions of Twist2and CD13are significantly associated with depth of tumor invasion,but the expressions of CD13are not with lymph node metastasis.The lower expressions of E-cadherin are significantly associated with depth of tumor invasion,lymph node metastasis and effect the survival time. Three factors indicate the important roles in the infiltration of gastric cancer.3.The Twist2expression is not correlative with prognosis of gastric cancer(P>0.05).,but the expressions of CD13and E-cadherin are correlative with prognosis of gastric cancer.4.The upregulation of Twist2may cause gastric epithelial transformate tumor issue. Because Twist2expression are closely related to the degree of tumor differentiation, it can be a biological marker of gastric cancer progression. Twist2 and CD13are positively correlated to some extent about tumor invasion, which can be the comprehensive judgment about tumor prognosis and guide treatment.