Postoperative autovaccinotherapy for patients with gastric cancer and expression of some proteins in tumor tissue.

AIM: To study the efficacy of autovaccine in the treatment of gastric cancer and significance of molecular factors having prognostic values for disease outcome to evaluate its efficacy in clinical setting. PATIENTS AND METHODS: 150 patients with histologically proven adenocarcinoma of the stomach of stages II, III or IV were enrolled into study. 86 patients have been treated with autovaccine (AV) after operation. Expression of p53, Bcl-2, receptors of tyrosine kinase, vascular endothelial growth factor (VEGF), capital IE, Cyrillic-cadherin, alpha-catenin and beta-catenin was determined in paraffin embedded tumor samples by means of immunohistochemical method with the use of respective monoclonal antibodies. RESULTS: It was shown that application of AV has resulted in the increase of 3-year overall survival of patients having stage III of disease by more than 30%, but those having stage IV - only around 14%. The increase of 3-year overall survival of patients with metastases in lymph nodes (N1-2) was observed also in more than 30%. It has been suggested the optimal phenotype for vaccine application: small er, Cyrillic53(+), EGFR(+), HER-2 neu (+), beta-catenin (+), VEGF(+) and Bcl-2(+) with no dependence on E-cadherin and alpha-catenin presence. CONCLUSION: It was determined that the best effect of AV application is observed in patients with category capital TE, Cyrillic3-4, poorly-differentiated tumors, metastases in lymph nodes (N1-2), but without distant metastases (capital EM, Cyrillic0). Gastric cancer patients with p53, EGFR, HER-2/neu, beta-catenin, VEGF and Bcl-2-positive tumors are the favorable group for the treatment with AV in the adjuvant regime.

Relation between cell-to-cell adhesion and angiogenesis and clinico-morphological prognostic factors in patients with gastric cancer.

AIM: To study the relation between the expression of the molecules of cell-to-cell adhesion (E-cadherin, alpha- and beta-catenins) and vascular endothelial growth factor (VEGF) and traditional clinico-morphological characteristics of tumors to evaluate their prognostic value in the patients with gastric cancer. METHODS: To analyze the expression of E-cadherin, alpha- and beta-catenins, and VEGF the paraffin embedded tumor samples were studied by immunohistochemical analysis with the use of respective monoclonal antibodies. RESULTS: The presence of E-cadherin in tumors correlated with the absence of metastases in regional lymph nodes and was observed, as a rule, in the patients at the early stages of the disease. The presence of beta-catenin expression has been detected in gastric tumors of the patients without distant metastases, while the level of VEGF expression correlated with the degree of gastric wall injury. It has been demonstrated that the expression of E-cadherin and alpha-catenin is associated with favourable disease course and is a characteristic pattern for early stages of gastric cancer of intestinal type. However, VEGF expression is typical for the late stages of gastric cancer of diffuse type and is associated with poor prognosis. CONCLUSION: At the base of combined clinical, histological and immunohistochemical analysis of gastric tumors it has been shown that E-cadherin, alpha-catenin and VEGF could be used as informative markers of the disease course.