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High DcR3 Expression Predicts Stage pN2-3 in Gastric Cancer

Wu, Yulian, MD; Guo, Enqi, MD; Yu, Junxiu, MD; Xie, Qiuping, MD

American Journal of Clinical Oncology: February 2008 - Volume 31 - Issue 1 - p 79-83
doi: 10.1097/COC.0b013e3180ca77ad
Original Article: Gastrointestinal

Background: A soluble decoy receptor 3 (DcR3), also known as TR6 or M68, is a member of the TNF receptor family. It has been reported that high DcR3 expression occurs in many tumors.

Methods: This prospective study evaluated the DcR3 tissue status by RT-PCR and its correlation with the lymph node (N) stages in 62 primary gastric cancers.

Results: DcR3 expression levels in patients with pN2-3 disease were much higher than those in patients with pN0-1 disease (median values 1.31 vs. 0, P < 0.01). Using ROC analysis, a cutoff level of DcR3 expression at 1.20 was found to be associated with optimal sensitivity and specificity of 62.5% (15 of 24) and 92.1% (35 of 38) respectively, in the prediction of stage pN2-3. According to the cutoff value, patients were divided into 2 groups with relatively high and low levels of DcR3 expression. Among the 18 patients with high DcR3 expression, 83.3% (15 of 18) were staged as pN2-3. In the other 44 patients with low DcR3 expression, only 20.5% (9 of 44) were identified as pN2-3. Logistic regression analysis for stage pN2-3 revealed that high DcR3 expression was an independent risk factor.

Conclusion: Gastric cancer patients with high DcR3 expression presented more advanced pN2-3 disease than those with low DcR3 expression. Preoperative checking DcR3 expression might be an additional approach to imaging modalities for evaluating N stages in gastric cancer to guide the operative procedures.

From the Department of Surgery, 2nd Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Supported by grants from the National Natural Science Foundation of China (nos. 30471697 and 30672072), Natural Science Foundation of Zhejiang, China (no. Z204033), and Foundation of Science and Technology Department of Zhejiang Province, China (no. 2006C23G2010216).

Reprints: Yulian Wu, MD, Department of Surgery, 2nd Affiliated Hospital, Zhejiang University School of Medicine, #88 Jiefang Road, Hangzhou, PR China 310009. E-mail:

© 2008 Lippincott Williams & Wilkins, Inc.