Abstract: Objective:To investigate the associations between expression of Tensin1 protein and clinicpathological characteristics and prognoses of gastric cancer (GC) patients.
Methods:The retrospective casecontrol study was conducted. The clinicopathological data of 163 GC patients who were admitted to the Affiliated Hospital of Jiangsu University between July 31, 2011 and December 31, 2013 were collected. The GC tissues and adjacent normal tissues were taken to paraffin imbedding, and then were detected by immunohistochemistry. Observation indicator: (1) expressions of Tensin1 protein in GC tissues and adjacent normal tissues; (2) association between expression of Tensin1 protein in GC tissues and clinicopathological characteristics; (3) followup and survival situations; (4) prognostic factors analysis. Followup using telephone interview was performed to detect survival up to January 1, 2017. Measurement data with skewed distribution were described as M (range). Count data were analyzed using the chisquare test or pairing chisquare test. The survival curve and rate were respectively drawn and calculated using the KaplanMeier method, and Log-rank test was used for survival analysis. The univariate analysis and multivariate analysis were done using the COX roportional hazard model.
Results:(1) Expressions of Tensin1 protein in GC tissues and adjacent normal tissues: immunohistochemistry showed that Tensin1 protein in GC tissues and adjacent normal tissues mainly expressed in cytoplasm. Of 163 patients, 154 (66 with high expression and 88 with low expression) and 9 had respectively positive and negative expressions of Tensin1 protein in GC tissues; 79 (37 with high expression and 42 with low expression) and 84 had respectively positive and negative expressions of Tensin1 protein in adjacent normal tissues, with statistically significant differences in positive expression ratio and expression levels (x²=64.65, 12.93, P<0.05). (2) Association between expression of Tensin1 protein in GC tissues and clinicopathological characteristics: high expression rate of Tensin1 protein in GC tissues were respectively 31.34%(21/67) in GC patients with tumor metastases and 46.88%(45/96) in GC patients without tumor metastasis, with a statistically significant difference (x²=3.95, P<0.05). (3) Followup and survival situations: all the 163 patients were followed up for 3.3-64.7 months, with a median time of 28.7 months. The 3year cumulative diseasefree survival rate and cumulative overall survival rate in GC tissues were 63.12%, 74.22% in 66 patients with high expression of Tensin1 protein and 47.30%, 55.74% in 97 patients with low and negative expressions of Tensin1 protein, showing statistically significant differences in above indicators (x²=4.58, 4.11, P<0.05). Survival analysis of subgroups showed that 3year cumulative diseasefree survival rate in GC tissues of patients with maximum tumor dimension ≥ 5 cm, nerve and / or vascular invasions and stage Ⅲ of TNM staging were 45.98%, 62.79%, 52.75% in patients with high expression of Tensin1 protein and 18.11%, 31.10%, 32.80% in patients with low and negative expressions of Tensin1 protein, with a statistically significant difference (x²=5.85, 7.89, 4.96, P<0.05). The 3year cumulative overall survival rate was respectively 66.00%, 75.75%, 67.93% in patients with high expression of Tensin1 protein and 30.74%, 40.15%, 44.67% in patients with low and negative expressions of Tensin1 protein, with statistically significant differences (x²=7.59, 9.62, 4.32, P<0.05). (4) Prognostic factors analysis: results of univariate analysis showed that maximum tumor dimension, histological grade, nerve and / or vascular invasions, postoperative TNM staging, postoperative adjuvant chemotherapy and expression of Tensin1 protein were related factors affecting prognoses of GC patients ［hazard ratio (HR)=3.66, 2.45, 2.17, 3.36, 0.41, 0.54, 95% confidence interval (CI): 2.09-6.41, 1.43-4.19, 1.17-4.04, 1.52-7.41, 0.23-0.72, 0.31-0.96, P<0.05］. Results of multivariate analysis showed that maximum tumor dimension ≥ 5 cm and grade Ⅲ of histological grade were independent risk factors affecting prognoses of GC patients (HR=3.21, 2.17, 95%CI: 1.63-6.32, 1.18-3.99, P<0.05), and postoperative adjuvant chemotherapy and high expression of Tensin1 protein were independent protective factors affecting prognoses of GC patients (HR=0.50, 0.44, 95%CI: 0.28-0.90, 0.24-0.82, P<0.05).
Conclusion:High expression of Tensin1 protein may inhibit GC metastasis, and it is also an independent protective factor affecting prognoses of GC patients.