The prognostic significance of vascular adhesion protein-1 levels in gastric cancer

Background: Gastric cancer is the second most common malignancy worldwide, with a high mortality rate. Vascular adhesion protein-1 (VAP-1) is a glycoprotein that mediates tissue-selective lymphocyte adhesion in sialic asid-dependent manner. The prognostic importance of VAP-1 was determined in various human cancers. There is only one study published about the relationship between gastric cancer and serum VAP-1 levels, in the literature. In this study that included only curative surgery performed gastric cancer patients, investigators have found a strong relationship between gastric cancer prognosis and serum VAP-1 levels. In our study involving gastric cancer patients with or without metastasis, we aimed to contribute to the literature about relationship between gastric cancer prognosis and serum VAP-1 levels.Material and method: The serum of the non-metastatic and metastatic gastric cancer patients was collected before treatment (surgery, radiotherapy and/or chemotherapy). Operable patients were treated with 5FU-leukovorin and radiotherapy according to schema for Intergroup-0116 after surgery and metastatic patients were treated with DCF protocol (75 mg/m2 docetaxel and cisplatin on day 1 and 750 mg/m2/day 5-FU infusion for 5 days, repeated every 3 weeks). VAP-1 levels were assayed by enzyme-linked immunosorbent assay.Results: Fifty four (62.8%) of the 86 patients were operated. The mean level of serum VAP-1 was 324.4 pg/ml. The mean concentration of serum VAP-1 in operable gastric cancer patients was significantly higher than that for metastatic gastric cancer patients (383.1±173.5 pg/ml vs. 225.2 ± 113.9, p<0.001). Serum VAP-1 levels were 533.9±204.4 pg/ml, 487,5,±129,4 pg/ml, 335.9±156.5 pg/ml and 225.2±113.9 pg/ml in patients with stage I, II, III and IV patients, respectively (p<0.001). When a cut-off value for VAP-1 was determined at =218.8 pg/mL by receiver operating characteristic (ROC) curves, sensitivity and specificity were 81.5% and 65.6% in gastric cancer patients, respectively. The patients with a decreased serum VAP-1 level had a significantly poorer prognosis than those with a serum VAP-1 level above the cutoff point (median 8.2 months vs 23.5 months, p<0.001).Conclusion: This study demonstrates that the relationship between serum VAP-1 levels and prognostik markers such as stage and presence of metastasis. In our study we detect that serum VAP-1 levels are independent prognostic factor of the gastric cancer.