Abstract
AIM: To study the relationship between Survivin and PTEN expression and lymph node metastasis, depth of invasion and prognosis of gastric cancer patients in China. METHODS: Specimens of gastric cancer tissue were collected from the Affiliated Hospital of Jianghan University. All the 140 patients had complete examination data. All lymph nodes were found by the fat-clearing method. The interrupted serial 4-micron sections, routine hematoxylin and eosin staining and immunohistochemical methods were used to detect the lymph node metastases. Gastric cancer tissue microarray was performed to test the expression of Survivin and PTEN (17A) in gastric cancer by immunohistochemical method. All data were processed using chi2 test, Fisher's exact test, Kaplan-Meyer Log-rank method and Cox multivariate analysis (SPSS 12.0 software). RESULTS: One hundred and eighteen specimens were used in our tissue microarray (utilization rate was 82.4%). A total of 7580 lymph nodes were found. Metastases were found in 90 specimens and 1618 lymph nodes were detected. The positive rate of Survivin and PTEN expression was 52.5% (62/118) and 76.2% (90/118), respectively. A highly positive correlation was found between Survivin and PTEN expression (chi2 = 4.17, P = 0.04). Survivin expression was positively correlated with UICC N stage (chi 2 = 8.69, P = 0.03) and histological classification (chi2 = 4.41, P = 0.04) by chi2 tests. PTEN expression was positively correlated with depth of invasion (P = 0.02) and histological classification (chi2 = 5.47, P = 0.02). But Survivin and PTEN expressions were not related with prognosis of gastric cancer patients. A significant correlation between lymph node metastasis and prognosis was demonstrated by Cox multivariate analysis (chi2 = 4.85, P = 0.028). CONCLUSION: Survivin is positively correlated with PTEN expression in gastric cancer and is a molecular marker of lymph node metastasis while PTEN expression is a molecular marker of advanced gastric cancer. UICC N stage is the most important prognostic factor of gastric cancer in China.