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Retinoid receptors in gastric cancer: expression and influence on prognosis
Kong-Wang Hu1, Fei-Hu Chen, Jin-Fang Ge
1Department of General Surgery, the First Hospital of Anhui Medical University, School of Pharmacology, Anhui Medical University, Hefei, China.
Background:
Gastric cancer is frequently lethal despite aggressive multimodal therapies, and new treatment approaches are therefore needed. Retinoids are potential candidate drugs: they prevent cell differentiation, proliferation and malignant transformation in gastric cancer cell lines. They interact with nuclear retinoid receptors (the retinoic acid receptors [RARs] and retinoid X receptors [RXRs]), which function as transcription factors, each with three subclasses, α, β and γ. At present, little is known about retinoid expression and influence on prognosis in gastric cancers.
Patients And Methods:
We retrospectively analyzed the expression of the subtypes RARα, RARβ, RARγ, RXRα, RXRβ, RXRγ by immunohistochemistry in 147 gastric cancers and 51 normal gastric epithelium tissues for whom clinical follow-up data were available and correlated the results with clinical characteristics. In addition, we quantified the expression of retinoid receptor mRNA using real- time PCR (RT-PCR) in another 6 gastric adenocarcinoma and 3 normal gastric tissues. From 2008 to 2010, 80 patients with gastric cancers were enrolled onto therapy with all-trans-retinoic acid (ATRA).
Results:
RARα, RARβ, RARγ and RXRγ positively correlated with each other (p<0.001) and demonstrated significantly lower levels in the carcinoma tissue sections (p<0.01), with lower RARβ, RARγ and RXRα expression significantly related to advanced stages (p<=0.01). Tumors with poor histopathologic grade had lower levels of RARα and RARβ in different histological types of gastric carcinoma (p<0.01). Patients whose tumors exhibited low levels of RARa expression had significantly lower overall survival compared with patients who had higher expression levels of this receptor (p<0.001, HR=0.42, 95.0% CI 0.24-0.73), and patients undergoing ATRA treatment had significantly longer median survival times (p=0.007, HR=0.41, 95.0% CI 0.21-0.80).
Conclusions:
Retinoic acid receptors are frequently expressed in epithelial gastric cancer with a decreased tendency of expression and RARa may be an indicator of a positive prognosis. This study provides a molecular basis for the therapeutic use of retinoids against gastric cancer.
Insights
Retinoic acid receptors (RARs) are expressed in gastric cancer, with lower levels linked to advanced disease. High RARα expression indicates a better prognosis, supporting retinoid therapy for gastric cancer.
Area of Science:
- Oncology
- Molecular Biology
- Cancer Therapeutics
Background:
- Gastric cancer necessitates novel treatments due to high lethality.
- Retinoids show promise in preventing gastric cancer cell differentiation, proliferation, and malignant transformation.
- Retinoid receptors (RARs and RXRs) are transcription factors with known roles in cellular processes.
Purpose of the Study:
- To investigate the expression of retinoic acid receptors (RARs) and retinoid X receptors (RXRs) in gastric cancer.
- To correlate receptor expression with clinical characteristics and patient prognosis.
- To explore the therapeutic potential of retinoids in gastric cancer treatment.
Main Methods:
- Immunohistochemistry was used to analyze RARα, RARβ, RARγ, RXRα, RXRβ, and RXRγ expression in 147 gastric cancers and 51 normal tissues.
- Real-time PCR quantified retinoid receptor mRNA in gastric adenocarcinoma and normal tissues.
- Clinical follow-up data were correlated with receptor expression, and outcomes for 80 patients treated with all-trans-retinoic acid (ATRA) were analyzed.
Main Results:
- RARα, RARβ, RARγ, and RXRγ expression correlated positively and were lower in gastric carcinoma tissues.
- Reduced RARβ, RARγ, and RXRα expression were linked to advanced tumor stages.
- Low RARα expression correlated with significantly poorer overall survival, while ATRA treatment improved survival rates.
Conclusions:
- Retinoic acid receptors are frequently expressed in gastric cancer, with a tendency for decreased expression.
- RARα expression may serve as a positive prognostic indicator in gastric cancer.
- This study provides a molecular rationale for using retinoids as a therapeutic strategy for gastric cancer.
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