Prognostic value of noggin protein expression in patients with resected gastric cancer

BackgroundNoggin and RNA-binding protein for multiple splicing 2 (RBPMS2) are known to regulate the expression of smooth muscle cells, endothelial cells, and osteoblasts. However, the prognostic role of combined Noggin and RBPMS2 expression in resected gastric cancer (GC) is unclear.MethodsA total of 163 patients with GC who underwent gastrectomy were included in this study. The expression of Noggin and RBPMS2 proteins in tumor cells at the tumor center and invasive front of resected GC was evaluated by immunohistochemistry, and in conjunction with clinicopathological parameters the patient survival was analyzed.ResultsRBPMS2 protein expression was high at the tumor center (n=86, 52.8%) and low at the invasive front (n=69, 42.3%), while Noggin protein expression was high in both tumor center (n=91, 55.8%) and the invasive front (n=90, 55.2%). Noggin expression at the invasive front and tumor center was significantly decreased in advanced T stage, non-intestinal-type (invasive front, P=0.008 and P< 0.001; tumor center lesion, P=0.013 and P=0.001). RBPMS2 expression at the invasive front was significantly decreased in non-intestinal-type and positive lymphatic invasion (P< 0.001 and P=0.013). Multivariate analysis revealed that high Noggin protein expression of the invasive front was an independent prognostic factor for overall survival (hazard ratio [HR], 0.58; 95% confidence interval [CI]; 0.35-0.97, P< 0.036), but not at the tumor center (HR, 1.35; 95% CI; 0.81-2.26, P=0.251).ConclusionsOur study indicates that high Noggin expression is a crucial prognostic factor for favorable outcomes in patients with resected GC.