BACKGROUND: Alterations in the activity of
transforming growth factor beta (
TGF-beta) in humans have been implicated in
fibrosis, immunosuppression, development of
cancer, and other disorders. Scirrhous gastric
carcinoma is characterized by
cancer cells that infiltrate rapidly in the stroma with extensive growth of fibroblasts and fibrous tissue. Hence, the majority of studies examining the role of
TGF-beta in gastric
carcinoma have focused on
scirrhous carcinoma.METHODS: We undertook a retrospective immunohistochemical study of gastric
carcinoma in order to characterize
TGF-beta expression in malignant gastric lesions and to determine whether
TGF-beta expression was related to
disease progression.RESULTS:
TGF-beta expression in scirrhous gastric
carcinomas was significantly higher than that in nonscirrhous gastric
carcinomas. In patients with advanced gastric
carcinoma with surgically curative resection,
TGF-beta expression was significantly higher in those patients who developed peritoneal recurrence after surgery than in those who did not develop such recurrence. Patients with
TGF-beta expression-positive
tumors had significantly poorer survival than did those with
TGF-beta expression-negative
tumors ( P = 0.017). In addition, multivariate Cox proportional hazard model analysis showed that
TGF-beta immunohistochemical status was an independent prognostic factor ( P = 0.0031).CONCLUSION: These data suggest that
TGF-beta may contribute, in part, to the variations in histogenesis and to the prevalence of peritoneal dissemination in gastric
carcinoma.