Originally published as JCO Early Release 10.1200/JCO.2004.00.2253 on September 6 2005

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Gene Expression Profile Predicts Patient Survival of Gastric Cancer After Surgical Resection

Chiung-Nien Chen, Jen-Jen Lin, Jeremy J. W. Chen, Po-Huang Lee, Ching-Yao Yang, Min-Liang Kuo, King-Jen Chang, Fon-Jou Hsieh

From the Department of Surgery, Traumatology, Graduate Institute of Clinical Research, National Taiwan University Hospital and College of Medicine; Laboratory of Molecular and Cellular Toxicology, Institute of Toxicology, College of Medicine; Angiogenesis Research Center, National Taiwan University; Department of Applied Statistics and Information Science, Ming Chuan University, Taipei; and the Institutes of Biomedical Sciences and Molecular Biology, National Chung Hsing University, Taichung, Taiwan

Address reprint requests to Fon-Jou Hsieh, MD, Graduate Institute of Clinical Research, or King-Jen Chang, MD, PhD, Department of Surgery, National Taiwan University Hospital and College of Medicine, No. 7, Chung-Shan S. Rd, Taipei, Taiwan; e-mail: fjhsieh{at}ha.mc.ntu.edu.tw or kingjen{at}ha.mc.ntu.edu.tw.

PURPOSE: This study was conducted to characterize gene expression profile of survival in patients with surgically curable gastric cancer by using an in-house membrane microarray and developing a survival prediction model.

MATERIALS AND METHODS: Data of cDNA microarrays were obtained from 18 pairs of cancerous and noncancerous gastric tissues. Nine patients who survived > 30 months were identified as good survival, and the other nine, who survived < 12 months, were identified as poor survival. Supervised analysis was performed to identify a gene expression profile by good and poor survival. Semiquantitative reverse transcriptase polymerase chain reaction (RT-PCR) was used to confirm the microarray data in 10 patients with sufficient RNA. Using these 10 patients and another 10 patients selected randomly from 40 newly enrolled patients as the training group, the RT-PCR status of the confirmed genes was used for predicting good versus poor survival. Finally, the prediction model was tested in the remaining 30 newly enrolled gastric cancer patients.

RESULTS: A survival prediction model consisting of three genes (CD36, SLAM, PIM-1) was developed. This model could correctly predict poor or good survival in 23 (76.7%) of 30 newly enrolled patients, and yielded a specificity of 80% and a sensitivity of 73.3%. The survival rate of the patients predicted to have good survival was significantly higher than that of those predicted to have poor survival in the test group as a whole (N = 30; P = .00531) and in stage III patients (n = 16; P = .04467).

CONCLUSION: The semiquantitative RT-PCR gene expression profiling of three genes extracted from microarray study can accurately predict surgery-related outcome in gastric cancer patients.

Supported by grant from National Science Council and Department of Industrial Technology, Ministry of Economic Affairs, Taipei, Taiwan.

F.J.H. and K.J.C. are joint senior authors.

Terms in blue are defined in the glossary, found at the end of this issue and online at www.jco.org.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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