Prognostic implication of TSC1 and mTOR expression in gastric carcinoma

J Surg Oncol. 2014 Jun;109(8):812-7. doi: 10.1002/jso.23585. Epub 2014 Feb 26.

Abstract

Background: Gastric adenocarcinoma is the sixth most common and third most lethal cancer in the world. Except for HER2-targeted therapy, targeted agents against specific molecules participating in gastric carcinogenesis, including those in the mechanistic target of rapamycin (serine/threonine kinase) (mTOR) pathway have not been proved to be effective. However, some studies have suggested that dysfunction of TSC1 may augment mTOR inhibitor activity.

Methods: We studied p-mTOR and TSC1 status by immunohistochemical analysis of gastric carcinoma samples using a tissue microarray method and expression values adopted from The Cancer Genome Atlas.

Results: High p-mTOR and low TSC1 expression status is associated with adverse clinicopathologic parameters. Patients with high p-mTOR levels showed poor survival. Patients with low TSC1 levels showed unfavorable survival status in the overall patients group. The combination of p-mTOR status and TSC1 status provided more strong survival information than using each parameter alone.

Conclusions: In gastric cancer, high p-mTOR expression level is a statistically significant parameter in multivariate and Kaplan-Meier analyses (log-rank test). In addition to p-mTOR, TSC1 expression provided additional information to predict survival. We therefore suggest that evaluation of both p-mTOR and TSC1 status may be helpful in clinical trials related to mTOR inhibitors.

Keywords: TSC1; bootstrap analysis; immunohistochemistry; mTOR protein; stomach neoplasms.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / metabolism*
  • Adenocarcinoma / mortality
  • Biomarkers, Tumor / metabolism*
  • Female
  • Follow-Up Studies
  • Humans
  • Immunoenzyme Techniques
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Phosphorylation
  • Prognosis
  • Stomach Neoplasms / diagnosis
  • Stomach Neoplasms / metabolism*
  • Stomach Neoplasms / mortality
  • Survival Rate
  • TOR Serine-Threonine Kinases / metabolism*
  • Tissue Array Analysis
  • Tuberous Sclerosis Complex 1 Protein
  • Tumor Suppressor Proteins / metabolism*

Substances

  • Biomarkers, Tumor
  • TSC1 protein, human
  • Tuberous Sclerosis Complex 1 Protein
  • Tumor Suppressor Proteins
  • MTOR protein, human
  • TOR Serine-Threonine Kinases