SIGNIFICANCE OF ESTROGEN-RECEPTORS AND CATHEPSIN-D TISSUE DETECTION IN GASTRIC ADENOCARCINOMA

Estrogen receptors (ERs) have recently been reported to be present in carcinomas of stomach, an organ that has so far been considered as non target for sex hormones. Cathepsin D is an estrogen-regulated lysosoma l protease that has been overexpressed in breast cancer. ER and cathep sin D immunohistochemical expression were studied in this research in order to estimate their association to known histopathological and cli nical parameters and their possible prognostic significance as well. S ixty-two patients with gastric adenocarcinomas were included in this s tudy. The cancers were studied immunohistochemically concerning ER pos itivity in tumor cell nuclei and cathepsin D cytoplasmic expression. N uclear ER staining was detected in tumor cells of 25% of male and 27% of female patients. ER positivity was demonstrated mainly in the well and moderately differentiated carcinomas; 87.5% of ER(+) tumors were a lso characterized as cathepsin D positive and a significant correlatio n between ER and cathepsin D positive expression was demonstrated (P < 0.05). Cytoplasmic cathepsin D expression was observed in carcinomato us cells of 70.9% of gastric tumors. Early tumor stage and good differ entiation were significantly associated with increased cathepsin D exp ression (P < 0.05, P < 0.001). Histologic type, degree of differentiat ion and tumor stage were significantly correlated to survival (P < 0.0 5, P < 0.001 and P < 0.001). The patients who were cathepsin D(+) had a significant prognostic advantage over the cathepsin D(-) patients (P < 0.001). The presence of ER and estrogen-regulated cathepsin D indic ates the involvement of sex hormonal factors in these tumors and cathe psin D positive expression in tumor cells seems to be related to bette r prognosis. Their biological, clinical, and prognostic roles remain t o be further elucidated. (C) 1995 Wiley-Liss, Inc.