Prognostic Value of CD133 and SOX2 Expression After Neoadjuvant Chemotherapy in Patients With Locally Advanced Gastric Cancer.

BACKGROUND: To investigate the expression and associations of putative stem cell markers with survival in patients with locally advanced gastric cancer (GC) receiving neoadjuvant chemotherapy. METHODS: This study included 180 patients with locally advanced GC who received neoadjuvant chemotherapy and subsequent radical gastrectomy between June 2010 and December 2014. Surgical paraffin samples from the enrolled patients were collected. Tissue microarrays were used to detect the expression patterns of 10 putative stem cell markers; immunohistochemistry was used to evaluate the expression patterns of CD133 and SOX2 in GC and adjacent tissues. The prognostic values of these tumor markers for survival in GC were evaluated. RESULTS: Following adjustments for sex and age, high CD133 and SOX2 expression levels after neoadjuvant chemotherapy were associated with poor survival in GC patients (p = 0.012 and = 0.022, respectively). Subgroup analysis showed that CD133 and SOX2 expression levels in the T(2-4) population after neoadjuvant chemotherapy were negatively associated with survival in GC patients (p = 0.017 and 0.036, respectively). The BAX expression level in the N(0) population after neoadjuvant chemotherapy was positively associated with survival in GC patients (p = 0.045). In the N(1+2+3) population, a higher E-cadherin expression level after neoadjuvant chemotherapy was associated with longer survival among GC patients (p = 0.006). CONCLUSIONS: The CD133 and SOX2 expression levels after neoadjuvant chemotherapy are independent predictors of survival in locally advanced GC patients receiving neoadjuvant chemotherapy, and higher CD133 and SOX2 expression levels were associated with lower mortality rates.