Overexpression of FIBCD1 Is Predictive of Poor Prognosis in Gastric Cancer

Chunyi Jiang, MA; Jinhong Zhu, MD; Pengcheng Zhou, MA; Huijun Zhu; Wei Wang, MA; Qin Jin, MA; Peng Li, MD

Disclosures

Am J Clin Pathol. 2018;149(6):474-48. 

In This Article

Results

FIBCD1 mRNA Level Was Significantly Higher in Gastric Cancer Tissues Than in Normal Tissues

To compare the expression level of FIBCD1 mRNA in gastric cancer and normal tissues, we isolated total RNA from 27 pairs of cancerous and adjacent normal tissues and performed quantitative PCR. The mean ± standard deviation FIBCD1 mRNA expression in cancerous tissue and adjacent normal tissue was 0.6308 ± 0.1988 and 0.1615 ± 0.04391, respectively. The expression level of FIBCD1 mRNA in cancerous tissues was significantly higher than that in adjacent tissues (P < .05; Figure 1 ).

Figure 1.

Messenger RNA (mRNA) expression of FIBCD1 in gastric cancer and normal tissues. FIBCD1 mRNA expression was significantly higher in cancerous tissues than in matched adjacent normal tissues (0.6308 ± 0.1988 vs 0.1615 ± 0.04391, P < .05).

FIBCD1 Protein Expression in Gastric Cancer by IHC

High FIBCD1 expression localized in nuclei was observed in 328 (63.07%) of 520 gastric cancer tissues compared with three (13.6%) of 22 for chronic gastritis, eight (18.6%) of 43 for intestinal metaplasia, nine (27.27%) of 33 for low-grade intraepithelial neoplasia, 12 (50.0%) of 24 for high-grade intraepithelial neoplasia, and nine (15.25%) of 59 for surgical margin in patients with gastric cancer Table 1 . FIBCD1 expression level was significantly higher in gastric cancer than in chronic gastritis, intestinal metaplasia, low-grade intraepithelial neoplasia, high-grade intraepithelial neoplasia, and surgical margin (patients with gastric cancer) (Pearson χ 2 = 97.788, P < .001).

Association of FIBCD1 Expression With Clinical Characteristics

The association between FIBCD1 expression and clinical characteristics of gastric cancer is shown in Table 2 . High expression of FIBCD1 was correlated with age (P = .011), tumor status (T) (P < .001), lymph node (N) (P = .005), metastasis (M) (P = .035), TNM stage (P < .001), level of preoperative serum CEA (P = .002), and the expression of HER-2 (P < .001) (Table 2). FIBCD1 expression had no significant association with sex, histologic type, tumor differentiation, or preoperative serum CA19-9 level (Table 2).

Overexpression of FIBCD1 Predicts Poor Prognosis in Gastric Cancer

Prognostic factors in patients with gastric cancer were analyzed by univariate and multivariate analysis. In univariate analysis, a number of factors showed a significant association with overall survival, including high expression of FIBCD1 (hazard ratio [HR], 3.609; P < .001), older age (HR, 1.295; P = .040), histologic type (HR, 1.118; P = .038), differentiation (HR, 1.306; P = .003), TNM stage (HR, 1.507; P < .001), tumor status (HR, 1.995; P < .001), lymph node status (HR, 1.709; P < .001), metastasis (HR, 3.594; P < .001), CEA level (HR, 1.790; P < .001), and CA19-9 level (HR, 2.449; P < .001) Table 3. In multivariate analysis, high expression of FIBCD1 (HR, 2.725; P < .001), advanced TNM stage (HR, 1.549; P < .001), and high CA19-9 level (HR, 1.645; P = .030) were independent prognostic factors for poor prognosis (Table 3). Kaplan-Meier survival analysis demonstrated that patients with gastric cancer with high FIBCD1 expression, advanced TNM stage, and high CA19-9 level had a significantly poorer prognosis Figure 2. Consistent with these results, the KM plotter indicated that high FIBCD1 expression was significantly correlated with inferior overall survival compared with low FIBCD1 expression (log-rank test: P < .001; Figure 3).

Figure 2.

Kaplan-Meier survival curves of patients with gastric cancer. A, Patients with high fibrinogen C domain containing 1 (FIBCD1) levels (green line, 1) had significantly worse overall survival than patients with low or no FIBCD1 levels (blue line, 0). P < .001 by log-rank test. B, Patients with advanced TNM stage had significantly shorter survival than patients with early TNM stage. P < .001 by log-rank test. C, Overall survival in patients with high CA19-9 expression (green line, 1) was worse than that in patients with low or no CA19-9 expression (blue line, 0). P < .001 by log-rank test.

Figure 3.

Bioinformatics analysis. The Kaplan-Meier plotter showed that patients with high tumor fibrinogen C domain containing 1 levels had significantly reduced survival compared with those with low expression levels (n = 1,065; log-rank test: P < .001). Hazard ratio = 1.84 (range, 1.42–2.38).

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