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High DcR3 expression predicts stage pN2 in gastric cancer
Yulian Wu1, Enqi Guo, Junxiu Yu
1Department of Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, PR China. wuyulian@medmail.com.cn
Background/Aims:
A soluble decoy receptor 3 (DcR3), also known as TR6 or M68, is a member of the TNF receptor family. It has been reported that high DcR3 expression occurs in many tumors.
Methodology:
This prospective study evaluated the DcR3 tissue status by RT-PCR and its correlation with the lymph node (N) stages in 62 primary gastric cancers.
Results:
DcR3 expression levels in patients with pN2 disease were much higher than those in patients with pN0-1 disease (Median values 1.31 vs. 0, P< 0.01). Using ROC analysis, a cut-off level of DcR3 expression at 1.20 was found to be associated with optimal sensitivity and specificity of 62.5% (15/24) and 92.1% (35/38) respectively, in the prediction of stage pN2. According to the cut-off value, patients were divided into two groups with relatively high and low levels of DcR3 expression. Among the 18 patients with high DcR3 expression, 83.3% (15/18) showed metastases to the second level lymph nodes. In the other 44 patients with low DcR3 expression, only 20.5% (9/44) had secondary nodal involvement. Logistic regression analysis for stage pN2 revealed that high DcR3 expression was an independent risk factor.
Conclusions:
Gastric cancer patients with high DcR3 expression presented more advanced pN2 disease than those with low DcR3 expression. Preoperative checking DcR3 expression might be an additional approach to imaging modalities for evaluating N stages in gastric cancer to guide the operative procedures.