J Cancer 2020; 11(11):3172-3179. doi:10.7150/jca.34929 This issue

Research Paper

TBX2 Expression predicts Tumor Recurrence and Adjuvant Chemotherapy Benefits in Gastric Cancer Patients following R0 Resection: a proposed approach for risk stratification

Jun Lu1,2,3*, Yu Xu4,5*, Yao-hui Wang1,2,3, Xiao-yan Huang1,2,3, Yuan Wu4,5, Jian-wei Xie1,2,3, Jia-bin Wang1,2,3, Jian-xian Lin1,2,3, Ping Li1,2,3, Chao-hui Zheng1,2,3, Ai-min Huang4,5✉, Chang-ming Huang1,2,3✉

1. Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
2. Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
3. Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China.
4. Department of Pathology, the School of Basic Medical Sciences, Fujian Medical University.
5. Institute of Oncology of Fujian Medical University, Fuzhou, China.
Jun Lu and Yu Xu contributed equally to this work and should be considered co-first authors
*Co-first authors with equal contributions to this work.

This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/). See http://ivyspring.com/terms for full terms and conditions.
Citation:
Lu J, Xu Y, Wang Yh, Huang Xy, Wu Y, Xie Jw, Wang Jb, Lin Jx, Li P, Zheng Ch, Huang Am, Huang Cm. TBX2 Expression predicts Tumor Recurrence and Adjuvant Chemotherapy Benefits in Gastric Cancer Patients following R0 Resection: a proposed approach for risk stratification. J Cancer 2020; 11(11):3172-3179. doi:10.7150/jca.34929. Available from https://www.jcancer.org/v11p3172.htm

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Abstract

Aims: TBX2 is related to tumor progression and drug resistance. However, the roles of TBX2 in gastric cancer (GC) remain unclear. Our study aims at investigating the clinical roles of TBX2 in GC.

Methods: The protein expression levels of TBX2 in fresh GC tissue (n=20) were investigated with Western blotting analyses. The correlation between TBX2 expression and its prognostic significance was evaluated by immunohistochemical analyses of 401 patients. The survival benefit of postoperative adjuvant chemotherapy (PAC) for patients was evaluated.

Results: The expression of TBX2 was increased in GC tissue compared with adjacent paracancerous tissue (p=0.020). Immunohistochemistry demonstrated that TBX2 expression was significantly associated with lymphovascular invasion (p=0.024) and lymph node metastasis (p=0.044). A high level of TBX2 expression was an independent indicator of unfavorable recurrence-free and overall survival (p=0.002 and p=0.033, respectively). The prognostic model incorporating TBX2 expression exhibited greater predictive accuracy than the primary model. More importantly, the benefit of PAC noted in stage II/III GC patients with low TBX2 expression was superior to high TBX2 expression.

Conclusion: TBX2 may be not only a useful prognostic marker for GC but also a predictive biomarker of response to PAC in stage II/III GC patients. The current findings warrant further verification.

Keywords: TBX2, gastric cancer, survival, adjuvant chemotherapy