Protein expression-based classification of gastric cancer by immunohistochemistry of tissue microarray

PLoS One. 2020 Oct 23;15(10):e0238836. doi: 10.1371/journal.pone.0238836. eCollection 2020.

Abstract

Recently, the Cancer Genome Atlas and Asian Cancer Research Group propose two new classifications system of gastric cancer by using multi-platforms of molecular analyses. However, these highly complicated and cost technologies have not yet been translated into full clinical utility. In addition, the clinicians are expected to gain more guidance of treatment for different molecular subtypes. In this study, we developed a panel of gastric cancer patients in population from Southern China using commercially accessible TMA and immunohistochemical technology. A cohort of 259 GC patients was classified into 4 subtypes on the basis of expression of mismatch repair proteins (PMS2, MLH1, MSH2, and MSH6), E-cadherin and p21 protein. We observed that the subtypes presented distinct prognosis. dMMR-like subtype was associated with the best prognosis, and E-cadherin-a subtype was associated with the worst prognosis. Patients with p21-High and p21-Ligh subtypes had intermediate overall survival. In multivariate analysis, the dMMR-like subtype remained an independent prediction power for overall survival in the model. We described a molecular classification of gastric cancers using clinically applicable assay. The biological relevance of the four subtypes was illustrated by significant differences in prognosis. Our molecular classification provided an effective and inexpensive screening tool for improving prognostic models. Nevertheless, our study should be considered preliminary and carries a limited predictive value as a single-center retrospective study.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antigens, CD / metabolism
  • Biomarkers, Tumor / metabolism
  • Cadherins / metabolism
  • China
  • Cohort Studies
  • Cyclin-Dependent Kinase Inhibitor p21 / metabolism
  • DNA Mismatch Repair
  • DNA-Binding Proteins / metabolism
  • Female
  • Humans
  • Immunohistochemistry
  • Male
  • Middle Aged
  • Mismatch Repair Endonuclease PMS2 / metabolism
  • MutL Protein Homolog 1 / metabolism
  • MutS Homolog 2 Protein / metabolism
  • Neoplasm Proteins / metabolism*
  • Prognosis
  • Retrospective Studies
  • Stomach Neoplasms / classification*
  • Stomach Neoplasms / metabolism*
  • Stomach Neoplasms / pathology
  • Tissue Array Analysis

Substances

  • Antigens, CD
  • Biomarkers, Tumor
  • CDH1 protein, human
  • CDKN1A protein, human
  • Cadherins
  • Cyclin-Dependent Kinase Inhibitor p21
  • DNA-Binding Proteins
  • G-T mismatch-binding protein
  • MLH1 protein, human
  • Neoplasm Proteins
  • PMS2 protein, human
  • MSH2 protein, human
  • Mismatch Repair Endonuclease PMS2
  • MutL Protein Homolog 1
  • MutS Homolog 2 Protein

Grants and funding

This work was supported by the National Natural Science Foundation of China (No. 81871905, No. 81700486), the Natural Science Foundation of Guangdong, China (2020A1515010953), the Science and Technology Program of Guangzhou, Chian (201906010052, 202002030288), and the Fundamental Research Funds for the Central Universities, SCUT (2017BQ113). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.