Clinicopathological and prognostic significance of epithelial gremlin1 expression in gastric cancer

Abstract

Background/Aim: Gastric cancer (GC) is one of the most common malignancies worldwide. Gremlin1 is an antagonist of bone morphogenetic proteins that plays a critical role in several biological processes including cancer biology. Materials and Methods: We immunohistochemically examined the expression and distribution of Gremlin1 in non-neoplastic gastric mucosa in a series of 159 GC cases. Results: Among 159 GC primary tumors, 59 (37%) were positive for Gremlin1. Gremlin1-negative GC cases showed significantly more advanced clinicopathologic factors and a trend toward intestinal-type GC. Gremlin1 expression was also frequently observed in MUC5AC-positive and G-type GC cases. Gremlin1-negative GCs had a poorer survival rate than Gremlin1-positive GCs (p=0.002). Univariate and multivariate analyses revealed that Gremlin1 expression is an independent predictor of survival in GCs. Conclusion: These results indicate that Gremlin1 could be involved in GC progression and may be a good marker of long-term survival in GC.