Prognostic value of a 25-gene assay in patients with gastric cancer after curative resection

• Published in: Scientific reports 2017-08, Vol.7 (1), p.7515-11, Article 7515
• Main Authors: Wang, Xiaohong, Liu, Yiqiang, Niu, Zhaojian, Fu, Runjia, Jia, Yongning, Zhang, Li, Shao, Duanfang, Du, Hong, Hu, Ying, Xing, Xiaofang, Cheng, Xiaojing, Li, Lin, Guo, Ting, Li, Ziyu, Ji, Qunsheng, Zhang, Lianhai, Ji, Jiafu
• Format: Article
• Language: English
• Subjects: 38/39; 692/4020/1503/1504/1829; 692/4028/67/70; Aged; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biomarkers, Tumor - genetics; Biomarkers, Tumor - metabolism; Chemotherapy; Chemotherapy, Adjuvant - methods; Data processing; DNA microarrays; Female; Gastric cancer; Gene Expression Regulation, Neoplastic; Genes; Humanities and Social Sciences; Humans; Hybridization; Male; Medical prognosis; Middle Aged; Mortality; Mortality risk; multidisciplinary; Neoplasm Proteins - genetics; Neoplasm Proteins - metabolism; Neoplasm Staging; Paraffin; Prognosis; Risk; Risk groups; Science; Science (multidisciplinary); Stomach Neoplasms - drug therapy; Stomach Neoplasms - genetics; Stomach Neoplasms - mortality; Stomach Neoplasms - surgery; Surgery; Survival Analysis; Transcriptome
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-017-07604-y

This study aimed to develop and validate a practical, reliable assay for prognosis and chemotherapy benefit prediction compared with conventional staging in Gastric cancer (GC). Twenty-three candidate genes with significant correlation between quantitative hybridization and microarray results plus 2 reference genes were selected to form a 25-gene prognostic classifier, which can classify patients into 3 distinct groups of different risk of mortality obtained by analyzing microarray data from 78 frozen tumor specimens. The 25-gene assay was associated with overall survival in both training ( P  = 0.017) and testing cohort ( P  = 0.005) (462 formalin-fixed paraffin-embedded samples). The risk prediction in stages I + II is significantly better than that in stages III. Analysis demonstrated that this 25-gene signature is an independent prognostic predictor and show higher prognostic accuracy than conventional TNM staging in early stage patients. Moreover, only high-risk patients in stage I + II were found benefit from adjuvant chemotherapy ( P  = 0.043), while low-risk patients in stage III were not found benefit from adjuvant chemotherapy. In conclusion, our results suggest that this 25-gene assay can reliably identify patients with different risk for mortality after surgery, especially for stage I + II patients, and might be able to predict patients who benefit from chemotherapy.