Epithelial and stromal syndecan-1 expression as predictor of outcome in patients with gastric cancer

The prognostic value of the immunohistochemical expression of epithelial an d stromal syndecan-1 was evaluated in 296 patients with gastric carcinoma. Formalin-fixed, paraffin-embedded specimens of gastric adenocarcinomas were stained with mouse monoclonal antibody B-B4 against human syndecan-1, Loss of immunoreactivity (less than or equal to 60% of cancer cells stained) wa s observed in 197 (67%) patients, Stromal immunoreactivity was observed in 28 (9%) patients. Loss of epithelial syndecan-1 immunoreactivity correlated with a higher stage of disease (stages II-IV), tumour location in the uppe r third of the stomach, nodal metastases (N1 or N2), positive stromal synde can-1 staining, deep tumour penetration (to subserosa or deeper = T2-T4), l arger tumour size (greater than or equal to5 cm) and intestinal type of can cer, No correlation between epithelial syndecan-1 immunoreactivity and age, gender, distant metastases, grade of differentiation or Borrmann classific ation was observed, Positive stromal syndecan-1 immunoreactivity correlated with decreased epithelial syndecan-1 expression, intestinal type of cancer and Borrmann type I. Patients with low epithelial syndecan-1 expression in cancer cells had worse overall survival than patients with strong epitheli al syndecan-1 staining (P = 0.0012), Stromal syndecan-1-positive patients h ad a worse outcome than patients with syndecan-1-negative stroma (P = 0.019 3), In Cox multivariate analysis, stromal syndecan-1 immunoreactivity was a prognostic factor independent of TNM stage, surgery for cure and tumour si ze. Thus, the immunohistochemical expression of syndecan-1 might be a predi ctor of outcome in patients with gastric adenocarcinoma. (C) 2001 Wiley-Lis s, Inc.