Key result
High periostin expression in intestinal type gastric cancer predicted favorable survival and lesser lymph node metastasis, with expression significantly higher than in diffuse type (P<0.001).
Why the study?
Changes in periostin expression play an important role in tumor initiation and progression, but its effect in gastric cancer patients undergoing gastrectomy required investigation.
Does periostin expression predict lymph node metastasis and survival in gastric cancer patients undergoing gastrectomy?
Cohort (n=747)
Does periostin expression predict lymph node metastasis and survival in gastric cancer patients undergoing gastrectomy?
High periostin expression in intestinal type gastric cancer predicts favorable survival and lesser lymph node metastasis.
May refine lymph node risk stratification in gastric cancer subtypes; hypothesis-generating and should not yet change practice.
Background and aim: Periostin is a protein from the Fascilin family. It is commonly present in normal tissues and is responsible for cell adhesion. Evidence has emerged showing that changes in periostin expression play an important role in tumor initiation, development, and progression. This study aims to investigate the effect of periostin in gastric cancer (GC) patients who underwent gastrectomy. Seven hundred and forty-seven GC patients who underwent gastrectomy between December 2006 and July 2011 were included in this study. Methods: Seven hundred and forty-seven cancer tissues and 70 paired adjacent normal tissues were collected. Periostin expression was evaluated by immunohistochemistry. The Gene Expression Omnibus database was used to study the association between the mRNA level and patient’s overall survival. The tumor microenvironment was also studied. Results: Periostin expression in stroma was downregulated in tumor tissues but it was upregulated in the epithelial cells. After dividing the tissues according to the Lauren Classification, we found that periostin expression in stroma and epithelial cells was higher in intestinal type than in diffuse type ( P <0.001 and P =0.010, respectively). Periostin was an independent predictor of lymph node (LN) metastasis in GC patients. The study of CD163(+) tumor-associated macrophages (TAMs) revealed that in diffuse type GC, periostin expression was associated with CD163(+) TAMs. Conclusion: We found that the periostin expression can predict LN metastasis in patients undergoing curative gastrectomy. Intestinal type GC patients with high periostin level had both a favorable survival and lesser LN metastasis.
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Zhang et al. (2018) conducted a cohort in Gastric cancer (n=747). Periostin expression vs. Low periostin expression was evaluated on Lymph node metastasis and overall survival. High periostin expression in intestinal type gastric cancer predicted favorable survival and lesser lymph node metastasis, with expression significantly higher than in diffuse type (P<0.001).
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