Clinical significance of nm23 expression and chromosome 17 numerical aberrations in primary gastric cancer

Prognostic value and clinicopathologic significance of nm23 in various cancers: A systematic review and meta-analysis

OBJECTIVE

Extensive studies have been carried out to investigate the association between nm23 expression and the prognosis and clinicopathologic significance of various tumors.

METHODS AND MATERIALS

Eligible studies were searched from Embase, China National Knowledge Infrastructure (CNKI), PubMed and Web of Science up to May 2017. In this study, we calculated the pooled hazard ratios (HRs) with 95% confidence intervals (95%CIs) to determine the association between nm23 expression and the prognosis of various tumors.

RESULTS

A total of 49 studies were finally included in the meta-analysis. The pooled HRs were 2.00 (95% CIs: 1.44-2.78) for overall survival (OS), 1.23 (95% CIs: 1.04-1.46) for disease-specific survival or progression-free survival (DFS/PFS), and 2.21 (95% CIs: 1.38-3.57) for survival of recurrence-free survival or metastasis-free survival (RFS/MFS). Moreover, the results indicated that low nm23 expression was significantly correlated with the lymph node metastasis (P = 0.002). For the subgroup analysis, the expression of nm23 in patients at N0 stage was obviously higher than the patients with breast carcinoma at N1-N3 stage [Odds ratio (OR) = 2.07, 95%CI (1.31, 3.26), P = 0.002]. Moreover, the expression of nm23 in the patients at N0 stage was remarkably higher than those at N1-N3 stages in the Chinese patients with breast carcinoma and those with nasopharyngeal carcinoma (P < 0.05). Whereas, no statistical difference was noticed in the expression of nm23 in patients of various age, gender, T stage, histological degree, TNM stage, respectively (P > 0.05).

CONCLUSION

Our study suggests that down-regulation of nm23 is related to poor prognosis in many cancers. The expression of nm23 in cancer tissues may serve as an important factor for evaluating the presence of lymph node metastasis.

Meta-Analysis of the Relationship between NM23 Expression to Gastric Cancer Risk and Clinical Features

The prognostic value of reduced NM23 expression for gastric cancer (GC) patients is still contradictory. Thus, we conducted a meta-analysis to quantitatively evaluate the association of NM23 expression with GC risk and clinical features by analyzing 27 publications. The result of our meta-analysis indicated that NM23 expression is markedly reduced in gastric cancer tissues (OR = 3.15; 95% CI = 1.97–5.03; P < 0.001). Furthermore, NM23 expression was negatively correlated with N stage, TNM stage, and histological grade. However, NM23 expression was not correlated with T stage, lymphatic invasion, vascular invasion, and 5-year overall survival rate. In conclusion, reduced NM23 expression correlated with gastric cancer risk, but its association with GC clinical features remains inconclusive. Therefore, large-scale and well-designed studies, which use uniform antibody and criterion of NM23 positive expression, are required to further validate the role of the NM23 in predicting GC progression.

Prognostic Value of NME1 (NM23-H1) in Patients with Digestive System Neoplasms: A Systematic Review and Meta-Analysis

OBJECTIVE

There is a heated debate on whether the prognostic value of NME1 is favorable or unfavorable. Thus, we carried out a meta-analysis to evaluate the relationship between NME1 expression and the prognosis of patients with digestive system neoplasms.

METHODS

We searched PubMed, EMBASE and Web of Science for relevant articles. The pooled odd ratios (ORs) and corresponding 95%CI were calculated to evaluate the prognostic value of NME1 expression in patients with digestive system neoplasms, and the association between NME1 expression and clinicopathological factors. We also performed subgroup analyses to find out the source of heterogeneity.

RESULTS

2904 patients were pooled from 28 available studies in total. Neither the incorporative OR combined by 17 studies with overall survival (OR = 0.65, 95%CI:0.41-1.03, P = 0.07) nor the pooled OR with disease-free survival (OR = 0.75, 95%CI:0.17-3.36, P = 0.71) in statistics showed any significance. Although we couldn't find any significance in TNM stage (OR = 0.78, 95%CI:0.44-1.36, P = 0.38), elevated NME1 expression was related to well tumor differentiation (OR = 0.59, 95%CI:0.47-0.73, P<0.00001), negative N status (OR = 0.54, 95%CI:0.36-0.82, P = 0.003) and Dukes' stage (OR = 0.43, 95%CI:0.24-0.77, P = 0.004). And in the subgroup analyses, we only find the "years" which might be the source of heterogeneity of overall survival in gastric cancer.

CONCLUSIONS

The results showed that statistically significant association was found between NME1 expression and the tumor differentiation, N status and Dukes' stage of patients with digestive system cancers, while no significance was found in overall survival, disease-free survival and TNM stage. More and further researches should be conducted to reveal the prognostic value of NME1.

Expressions of nucleoside diphosphate kinase (nm23) in tumor tissues are related with metastasis and length of survival of patients with hepatocellular carcinoma

OBJECTIVE

To evaluate the relationship of expressions of nucleoside diphosphate kinase (nm23) and proliferating cell nuclear antigen (PCNA), as well as apoptosis, with the prognosis of HCC patients by analyzing their pathological and clinical data.

METHODS

The expressions of nm23 and PCNA were analyzed by immunohistochemistry and the apoptotic phenomena were detected by TUNEL technique in the liver samples from 43 HCC tissues, 39 para-neoplastic tissues, and 10 normal tissues. The mean apoptosis index (AI) and proliferative index (PI) in individual sample were calculated.

RESULTS

As shown by the detection, 32.6% of carcinomas had negative nm23 signal in tumor tissues, whereas all para-neoplastic and normal tissues had positive nm23. The AI in nm23 positive HCC was significantly higher than that in nm23 negative one, with statistical difference (P<0.05). Furthermore, the expressions of nm23, and the values of AI and PI were contrastively analyzed with some main pathological and clinical data of HCC. It revealed that HCC with extrahepatic metastasis showed remarkable correlation with the negative nm23 (P=0.013) and higher PI values of HCC (P=0.015). The disease-free survival in HCC patients with negative nm23 expression was significantly poorer than that in patients with positive nm23 expression.

CONCLUSIONS

These data suggest that expressions of nm23 protein in tumor tissues are correlated with occurrences of metastasis and length of survival of the HCC patients, which may be an indicator for their prognosis.

Molecular staging of gastric cancer

Gastric cancer has traditionally been staged using purely histological methods, but these methods provide little information about the biology of gastric cancer and have limited predictive power. Recent studies have shown that clinically relevant gastric cancer subtypes have distinct gene expression profiles. This approach, termed molecular staging, can lead to the discovery of novel diagnostic and prognostic biomarkers of gastric cancers. This update reviews advances in molecular staging of gastric cancer and discusses their implications for the prognosis and diagnosis of this complex disease. Technologies used in molecular staging as well as future directions for the optimization of molecular staging of gastric cancer are also discussed.

Read-through transcript from NM23-H1 into the neighboring NM23-H2 gene encodes a novel protein, NM23-LV

NM23-H1 and NM23-H2 are neighboring genes on chromosome 17q. They encode nucleoside diphosphate kinases that have additional roles in signal transduction, transcription, and apoptosis. NM23-H1 expression is a strong marker for prognosis and metastatic behavior in many tumor types. A new bioinformatic tool, TranscriptView, identified read-through transcripts that start in the NM23-H1 gene and continue in the neighboring NM23-H2 gene. Splicing results in a transcript containing exons 1 to 4 of NM23-H1 and exons 2 to 5 of NM23-H2. The resulting mRNA encodes a novel and long variant of the NM23 protein family, NM23-LV, which contains part of NM23-H1 and the complete NM23-H2 protein. The transcript was amplified and sequenced from two neuroblastoma cell lines, confirming the presence of the predicted NM23-LV mRNA in vivo. Tissue analysis showed that NM23-LV is ubiquitously expressed, with the exception of the kidney. Neuroblastoma tumors show high-level expression of NM23-H1 and-H2 as well as NM23-LV mRNA. In neuroblastoma cells, the NM23-LV protein has mainly a cytoplasmic localization, but some nuclear staining was observed as well.

Gastric cancer related gene expression spectrum in disease pattern of traditional Chinese medicine

AIM

To find difference in gene expression pedigree of gastric carcinoma tissue and different syndrome, and its significance in the exploration of the syndrome typ and diagnosisof gastric carcinoma, with gene diagnosis as well as the use of drugs in its treatment.

METHODS

The gene expression in two TCM syndrome types of gastric carcinoma due to internal stagnancy of pathogenic heat and stagnancy of qi and blood stasis, respectively, including 4 human gastric carcinoma tissues and normal embryo stomach tissue, was analyzed by using 4096 pieces of human full-length genic CDNA expression CMOS chip technology.

RESULTS

The gene expression in the two TCM syndrome types of gastric carcinoma was decreased in their immune associated genes, but increased in cancer-associated genes. Gene expression in the interior stagnancy of toxic heat showed that the body resistance was not weakened, suggesting that there was no deficiency of qi and stagnancy of blood stasis

CONCLUSION

The change in gene expression of gastric cancer is identical, but the gene expression spectrum is different in different types of TCM syndromes.