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Caspase 3 expression correlates with patient outcomes in gastric adenocarcinoma after gastrectomy Taipei Veterans General Hospital, Department of Surgery, Division of General Surgery National Yang-Ming University 黃國宏楊慕華方文良吳秋文石宜銘

Introduction Gastric cancer is the 5th most common cancer and 3nd leading cause of cancer related death worldwide International Journal of Cancer (GLOBOCAN 2012) 2015; 136:E359-386 p<0.001 stage IA (86.9%) stage IB (83.8%) stage IIA (75.8%) stage IIB (63%) stage IIIA (42.8%) stage IIIB (31.6%) stage IIIC (12.7%) stage IV (8.7%)

Introduction Caspase-3 (CASP3) is a major executioner protein of proteolytic degradation during apoptosis. Caspase-3 downregulation (CASP3/DR) in tumors frequently confers resistance to cancer therapy and is significantly correlated with a poor prognosis in cancer patients. The role of Caspase 3 in gastric cancer has not been investigated yet.

Caspase 3 Apoptosis can be initiated through one of two cell-signaling pathways. Both pathways converge on caspase-3, a protein that acts as the cell’s executioner. PAC-1 (Procaspase Activating Factor-1, see below) bypasses both pathways and initiates apoptosis by inducing procaspase-3 to cleave itself to yield active caspase-3.

Patients and Methods 366 gastric cancer patients after curative gastrectomy Using Immunohistochemical(IHC) stains. Clinicopathological appearances and survival data were analyzed. IHC score 0 : < 5 % positive cells, 1+: 5–25 % positive cells 2+:26–75 % positive cells 3+: >75 % positive cells

Panoremic Viewer

Positive and negative control

Immunohistochemical stains

-: 241 patients Results 1+: 84 patients 2+: 32 patients 3+: 9 patients Positive rate--34.2%

Overall survival

Disease free survival

AJCC TNM Stage Stage I Stage II Stage III

Discussion Our studies revealed that gastric cancer patients with Caspase 3 expression had better prognosis than those without. Caspase 3 could be a potential prognostic biomarker in gastric cancer patients who received curative surgery.

Discussion Caspase 3 expression is associated with better clinicopathological appearances and may act as a tumor suppressor in human gastric cancer. Further studies, such as in vitro and in vivo studies, are necessary to demonstrate the mechanism of Caspase 3 on the role of carcinogenesis in gastric cancer.

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