Prognostic significance of insulin-like growth factor II mRNA-binding protein 3 expression in gastric adenocarcinoma

Background: Insulin-like growth factor II mRNA-binding protein (IMP) 3 is expressed in embryonic tissues and multiple cancers. The aim was to establish the prognostic value of IMP-3 expression in gastric adenocarcinoma. Methods: IMP-3 expression in resected gastric adenocarcinomas was analysed by immunohistochemistry. Results: IMP-3 was expressed in 183 (58.1 per cent) of 315 tumours. Expression was associated with older age (P < 0.001), larger tumour size (P = 0.009), deep tumour invasion (P < 0.001) and lymph node metastasis (P < 0.001). IMP-3-positive tumours were associated with poorer 5-year survival than negative tumours at all stages (stage I, 82 versus 97 per cent; stage II, 55 versus 78 per cent; stage III and IV, 11 versus 25 per cent; P = 0.005, P = 0.033 and P = 0.036 respectively). Multivariable analysis identified IMP-3 (hazard ratio (FIR) 1.93), depth of tumour invasion (HR 3.69, 9.77 and 10.69 for pathological turnout stage (pT) 2, pT3 and pT4 respectively versus pT1), and lymph node metastasis (HR 1.57, 3.29 and 3.40 for pathological node stage (pN) 1, pN2 and pN3 respectively versus pN0) as independent prognostic factors. Conclusion: IMP-3 expression correlates with the metastatic potential of gastric adenocarcinoma and is an independent prognostic factor.