Clinical Research
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Mar 28, 2006; 12(12): 1924-1932
Published online Mar 28, 2006. doi: 10.3748/wjg.v12.i12.1924
Molecular markers (PECAM-1, ICAM-3, HLA-DR) determine prognosis in primary non-Hodgkin’s gastric lymphoma patients
Alexander Darom, Ilias P Gomatos, Emmanuel Leandros, Emmu Chatzigianni, Dimitris Panousopoulos, Manousos M Konstadoulakis, George Androulakis
Alexander Darom, Ilias P Gomatos, Emmanuel Leandros, Emmu Chatzigianni, Dimitris Panousopoulos, Manousos M Konstadoulakis, George Androulakis, Laboratory of Surgical Research, First Department of Propaedeutic Surgery, Athens Medical School, Hippokration Hospital of Athens, 114 Q. Sofia Ave, 11527 Athens, Greece
Supported by the Athens University and the Greek Ministry of Health and Welfare
Correspondence to: Ilias P Gomatos MD, Kalvou 24, Old Psichiko, 154 52 Athens, Greece. labsures@yahoo.com
Telephone: +30-210-7486534 Fax: +30-210-6722259
Received: June 20, 2005
Revised: July 2, 2005
Accepted: August 19, 2005
Published online: March 28, 2006
Abstract

AIM: To investigate the prognostic significance of PECAM-1, ICAM-3 and HLA-DR antigens in patients with primary non-Hodgkin's gastric lymphoma.

METHODS: We immunohistochemically studied PECAM-1, ICAM-3 and HLA-DR antigen expression in 36 B-cell MALT-type primary gastric lymphoma patients. Ten non-malignant and ten healthy gastric tissue specimens were used as controls. Clinicopathological and survival data were correlated with the staining results.

RESULTS: HLA-DR antigen expression was detected in 33 gastric lymphoma patients (91.7%) and 6 non-malignant patients (54.5%). PECAM-1 stained tumor cells of 10 patients (27.8%), endothelial cells of 9 patients (25%) and inflammatory infiltrate of 4 patients (40%) with benign gastric disease. ICAM-3 expression was observed on the tumor cells of 17 patients (47.2%), while 5 non-malignant patients (50%) were stained positive as well. None of the healthy controls was stained for any of the genes studied. In the multivariate analysis, HLA-DR antigen and PECAM-1 were proved to be statistically significant independent prognostic factors associated with a favourable and an unfavourable prognosis respectively (P = 0.009 and P = 0.003). In the univariate analysis, PECAM-1(+)/ICAM-3(-) and HLA-DR(-)/ICAM-3(-) patients exhibited a significantly decreased overall survival compared to those with the exactly opposite gene expression patterns (P = 0.0041 and P = 0.0091, respectively). Those patients who were HLA-DR(+)/ICAM-3(+)/PECAM-1(-) (n = 8) had a significantly higher survival rate compared to the rest of the group (n = 24) (P = 0.0289).

CONCLUSION: PECAM-1, ICAM-3 and HLA-DR are representative markers of tumor expansion potential and host immune surveillance respectively. Their combined use may help us to identify high-risk patients who could benefit from more aggressive therapeutic protocols.

Keywords: PECAM-1, ICAM-3, HLA-DR, Non-Hodgkin's gastric lymphoma, Prognosis