1. ¹Department of Digestive and General Surgery, Shimane Medical University, Izumo, Japan
2. ²Department of Central Pathological Laboratory, Shimane Medical University, Izumo, Japan
3. ³Department of Anatomy, Shimane Medical University, Izumo, Japan
4. ⁴Gastroenterology Division and Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts

Correspondence: Dr. Dipok Kumar Dhar, Department of Digestive and General Surgery, Shimane Medical University, Izumo 693-8501, Japan. E-mail: nigeka33@shimane-med.ac.jp

Received 4 June 2003.

Abstract

Trefoil factor family 2 (TFF2) is a small peptide constitutively expressed in the gastric mucosa, where it plays a protective role in restitution of gastric mucosa. TFF2 has also been shown to be expressed in some gastric cancers, but its role in tumor metastasis and patient prognosis has not been examined. In this study, we examined TFF2 expression at both the mRNA and protein levels and correlated these results with the clinicopathologic characteristics and prognosis of gastric cancer patients. Among the 144 curatively resected samples, 43 (30%) were positive for TFF2. TFF2 expression was preferentially observed in the infiltrating tumor cells sparing the superficial cells. Significantly increased expression of TFF2 was noted in large tumors of the diffuse type. An increased prevalence of TFF2 expression was also found in tumors with advanced T and N stage and in patients with lymphatic and venous invasion. Accordingly, patients with TFF2-expressing tumors had a significantly worse disease-free survival, and in multivariate analysis, this finding remained significant as an independent prognostic factor. Taken together, our results suggest that TFF2 expression may play a role in gastric cancer invasion and as such could be a useful target for therapeutic intervention.