The Expression Of Midkine And Its Receptor In Gastric Cardiac Carcinoma And Its Clinical Significance

Objective: To investigate the expression and significance of Midkine andSyndecan-1in gastric cardiac adenocarcinoma (GCA) and analyze their relationshipbetween the expression of Midkine (MK) and Syndecan-1in gastric cardiac cancer andthe biological behavior and prognosis of gastric cardiac cancer.Methods: Surgical specimens used for this study were obtained from72patientswith gastric cardiac adenocarcinoma， which were confirmed pathologically andembedded in paraffin at The first affiliated hospital of Henan university of science andtechnology from Jan．2007to June．2010．72cases of GCA including56males and16females were recruited. All the samples including72gastric cardiacadenocarcinoma,26Atypical hyperplasia tissue and40normal mucosa specimenswhich were5cm far from gastric cardiac adenocarcinoma.Expression status ofMidkine and Syndecan-1was analyzed by immunohistochemistry in normal cardiacmucosa, atypical hyperplasia and gastric cardiac carcinoma tissues. Statistical analysiswas performed with SPSS17.0statistics software package.Results:1.The positive rate of Midkine was76.4%,26.9%and5%in GCA,atypical hyperplasia and normal gastric cardiac mucosa, respectively. The positive rateof Syndecan-1were38.9%,76.4%and100%in GCA, atypical hyperplasia andnormal gastric cardiac mucosa, respectively. The results show a significant differenceamong the three group both for Midkine and Syndecan-1(P<0.05).2. The expressionstatus of Midkine was not associated with patient age, sex, tumor size and the gradesof differentiation (P>0.05), but statistically positively correlated with infiltrative depthof tumor, lymph node metastasis and prognosis of patients (P<0.05); Syndecan-1expression was not correlated with the patient’s age, sex, tumor size (P>0.05), but,negatively correlated with the grades of differentiation, serosal membrane invasion,lymph node metastasis and prognosis of patients (P<0.05).3. Midkine positiveexpression of55cases of cardiac cancer, the positive expression of Syndecan-1in16 cases (29.1%), and in the negative Midkine expression of17cases of cardiac cancer,the positive expression of Syndecan-1to12cases (70.5%), by the Spearmancorrelation test, the expression of MK and Syndecan-1in the GCA tissues wasreversely correlated (r=-0.362, P<0.01).4.72patients’ postoperative follow-up of32~48months shows that as of47cases died in January2012,25patients survival,survival rates were37.5%at3years. The survival analysis showed that three yearssurvival rate in Midkine positive group and negative group were29.80%and66.70%，respectively. The two survival curve have significant difference (P=0.027).The survival analysis showed that three years survival rate in Syndecan-1positivegroup and negative group were53.60%and27.30%，respectively. The two survivalcurve have significant difference (P=0.019).Conclusions:(1)MK positive expression is closely correlated with tumordevelopment, progression and prognosis in gastric cardia cancer, so may be used as avaluable tumor marker and prognostic indicator.Midkine may be a promising tumormarker of gastric cardia cancer for diagnosis．(2) Syndecan-1are significantly relatedto clinical stage and metastasis for gastric cardiac cancer．(3) Midkine and Syndecan-1has negative correlation in gastric cardia cancer tissue． Loss of Syndecan-1expression and high Midkine expression may have synergistic action in the occurrenceof gastric cardia cancer, joint detection about Midkine and Syndecan-1may providedmore biological information for the clinical detection and diagnosis of gastric cardiacancer.