1. ¹Department of Surgical and Molecular Pathology, Dokkyo University School of Medicine, Tochigi, Japan
2. ²Department of Gastroenterology, Dokkyo University School of Medicine, Tochigi, Japan
3. ³Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Kyoto, Japan

Correspondence: Dr H Fukui, MD, PhD, Department of Surgical and Molecular Pathology, Dokkyo University School of Medicine, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan. E-mail: h-fukui@dokkyomed.ac.jp

Received 4 August 2008; Revised 7 November 2008; Accepted 7 November 2008; Published online 27 March 2009.

Abstract

Regenerating gene family members 1 (REG I) and 4 (REG IV) are overexpressed in a subset of gastric cancers. However, comparative characterization of the expression of these family proteins has remained unclear. Therefore, we aimed to elucidate not only the association between REG protein expression and mucin phenotype but also their significance as a prognostic marker for patients with gastric cancer. The expression of REG I, REG IV, CDX2, MUC2, and MUC5AC in gastric cancer tissues was examined by immunohistochemistry. The relationship between REG protein expression and clinicopathological parameters or mucin phenotype was then analyzed. REG I and REG IV expression was positive in 33 (52%) and 31 (49%) of 63 gastric cancers examined, respectively. REG I expression was significantly related to venous invasion and tumor stage, whereas REG IV expression showed no relationship to clinicopathological features. With regard to mucin phenotype, REG IV expression was significantly correlated with MUC2 and CDX2 expression, suggesting an association with the intestinal mucin phenotype of gastric cancer. On the other hand, REG I expression had no correlation with MUC2, CDX2, or MUC5AC in gastric cancer tissues. Expression of REG I but not REG IV was an independent predictor of poor outcome in patients with gastric cancer. In addition, patients with gastric cancer negative for both REG I and REG IV expression had a significantly better outcome than patients positive for either REG I or REG IV. Profiling of REG protein expression is useful to for prognostication of patients with gastric cancer.