Survivin gene levels in the peripheral blood of patients with gastric cancer independently predict survival
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BioMed Central
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Survivin gene levels in the peripheral blood of patients with gastric cancer independently predict survival Loris Bertazza1,2, Simone Mocellin*1, Alberto Marchet1, Pierluigi Pilati1, Joseph Gabrieli1, Romano Scalerta1 and Donato Nitti1 Address: 1Department of Oncological & Surgical Sciences, Section of Clinica Chirurgica 2, University of Padova, via Giustiniani 2, 35128, Padua, Italy and 2Istituto Oncologico Veneto IRCCS, via Gattamelata 64, 35128, Padua, Italy Email: Loris Bertazza - [email protected]; Simone Mocellin* - [email protected]; Alberto Marchet - [email protected]; Pierluigi Pilati - [email protected]; Joseph Gabrieli - [email protected]; Romano Scalerta - [email protected]; Donato Nitti - [email protected] * Corresponding author
Published: 22 December 2009 Journal of Translational Medicine 2009, 7:111
doi:10.1186/1479-5876-7-111
Received: 24 August 2009 Accepted: 22 December 2009
This article is available from: http://www.translational-medicine.com/content/7/1/111 © 2009 Bertazza et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: The detection of circulating tumor cells (CTC) is considered a promising tool for improving risk stratification in patients with solid tumors. We investigated on whether the expression of CTC related genes adds any prognostic power to the TNM staging system in patients with gastric carcinoma. Methods: Seventy patients with TNM stage I to IV gastric carcinoma were retrospectively enrolled. Peripheral blood samples were tested by means of quantitative real time PCR (qrtPCR) for the expression of four CTC related genes: carcinoembryonic antigen (CEA), cytokeratin-19 (CK19), vascular endothelial growth factor (VEGF) and Survivin (BIRC5). Results: Gene expression of Survivin, CK19, CEA and VEGF was higher than in normal controls in 98.6%, 97.1%, 42.9% and 38.6% of cases, respectively, suggesting a potential diagnostic value of both Survivin and CK19. At multivariable survival analysis, TNM staging and Survivin mRNA levels were retained as independent prognostic factors, demonstrating that Survivin expression in the peripheral blood adds prognostic information to the TNM system. In contrast with previously published data, the transcript abundance of CEA, CK19 and VEGF was not associated with patients' clinical outcome. Conclusions: Gene expression levels of Survivin add significant prognostic value to the current TNM staging system. The validation of these findings in larger prospective and multicentric series might lead to the implementation of this biomarker in the routine clinical setting in order to optimize risk stratification and ultimately personalize the therapeutic management of these patients.
Background Gastric cancer repres
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