Prognostic value of tumoral expression of galectin-9 in gastric cancer.

BACKGROUND/AIMS: Galectin-9 (Gal-9) is a member of the ß-galactoside-binding lectin family. Our previous study revealed that Gal-9 suppresses migration, invasion, and epithelial-mesenchymal transition in gastric cancer cells. Gal-9 was reported to have anti-metastatic activity in patients with malignant melanoma, breast cancer, and hepatocellular carcinoma. Therefore, we aimed to evaluate the prognostic significance of Gal-9 in patients with gastric cancer. MATERIALS AND METHODS: The clinical significance of Gal-9 was explored using clinical and pathological data from 619 patients with gastric cancer who underwent gastrectomy at National Cancer Center, Korea. Tissue microarray and immunohistochemical analyses were used to evaluate Gal-9 expression. The median follow-up duration was 65.7 months (range 0-79 months). Kaplan-Meier method was used to evaluate survival. Log-rank test was used to assess the differences in survival. RESULTS: Based on the tumoral expression of Gal-9, 619 patients with gastric cancer were classified into two groups: Gal-9-positive patients (327, 52.8%) and Gal-9-negative patients (292, 47.2%). The Gal-9-positive group had a significantly lower overall (p=0.001, by log-rank test) and gastric cancer-specific mortalities (p<0.001) compared to the Gal-9-negative group. In multivariate analysis, which included the depth of invasion and lymph-node metastasis, Gal-9 positivity showed a trend toward improved prognosis but did not reach statistical significance (hazard ratio, 0.8; 95% confidence interval, 0.55-1.31). CONCLUSION: Tumoral expression of Gal-9 may suppress tumor progression in patients with gastric cancer.

The impact of mitral annular calcification on left ventricular function in nonagenarians.

BACKGROUND AND OBJECTIVES: Mitral annular calcification (MAC) is known to be associated with degenerative processes of the cardiac fibrous skeleton and cardiovascular disease mortality. However, MAC has not been evaluated in an extreme age group (patients >/=90 years of age). In this study, the clinical significance of MAC associated with aging was examined in this age group and compared with MAC associated with aging in a younger (20 to 50 years of age) group of patients. SUBJECTS AND METHODS: We assessed echocardiographic parameters in 43 nonagenarians and 51 young patients. In the nonagenarian group, patient's age was 92+/-2 years and 27% were male; in the young control group, patient's age was 36+/-9 years and 51% were male. Comprehensive M-mode and Doppler echocardiography, including tissue Doppler imaging, were performed. The frequency and severity of MAC was assessed from the leading anterior to the trailing posterior edge at its largest width for least 3 cardiac cycles. RESULTS: Echocardiography showed that the left ventricular (LV) end-diastolic dimension was larger in the young controls (p=0.007); however, the ejection fraction (EF) was lower in the nonagenarian group (p=0.001). The frequency of MAC was greater in nonagenarians {42/43 (97%)} than in controls {9/51 (17%), p<0.0001}. The maximal width of MAC was larger in nonagenarians (0.52+/-0.17 mm and 0.05+/-0.13 mm, p<0.0001). MAC was correlated with LV mass index (g/m(2)) (r=0.280, p=0.014) and EF (%) (r=-0.340, p=0.001). More importantly, early mitral inflow velocity/early diastolic mitral annulus velocity (E/E') was strongly correlated with MAC in non-agenarians (r= 0.683, p<0.0001). CONCLUSION: MAC may be associated with extreme age and increased LV filling pressure in nonagenarians. Further study is necessary to assess the cardiovascular mortality and structural changes related to mitral annulus calcification associated with aging.