Role of glucocorticoid receptor in serosa-involved gastric carcinoma after gastrectomy.

Glucocorticoid receptor (GR) was first found in the cytosol of gastric cancer tissue more than 15 years ago. At present, most gastric cancers are diagnosed at the advanced stage. To elucidate the role of GR in gastric cancer, the GR levels of the cancer tissue of 75 consecutive patients with grossly serosa-involved gastric carcinoma were determined by the dextran-coated charcoal method. The clinicopathologic characteristics and long-term survival duration were compared in patients with GR-positive and GR-negative cancer cells. We found that GR could be detected in the cytosol of cancer cells in 31 (41.3%) of the gastric cancer patients with a median concentration of 18.5 (range, 1.03-73.9) fmol/mg protein. No significant differences could be found in any clinicopathologic characteristic between the patients with GR-positive and GR-negative cancers. After multivariate analysis, gross Borrmann's type, metastatic lymph node number, and GR positivity were the independent prognostic factors after gastrectomy for serosa-involved gastric carcinoma. GR-positive gastric cancer had a worse survival rate than GR-negative gastric cancer. Multimodality adjuvant therapies should be considered in patients with GR-positive serosa-involved gastric carcinoma.

Roles of the glucocorticoid receptor in resectable hepatocellular carcinoma.

BACKGROUND: The glucocorticoid receptor (GR) was discovered in the cytosol of hepatocellular carcinoma (HCC) cells more than 10 years ago. However, the influence of the GR on the prognosis of HCC after liver resection remains unclear. METHODS: Ninety-two consecutive patients with HCC who survived liver resection and who did not receive any preoperative neoadjuvant therapy were enrolled in this study. The GR level in cytosol of cancerous tissue was determined by the dextran-coated charcoal method. The clinicopathologic characteristics and long-term prognosis of patients with GR-positive tumors (GR-positive group) were compared with those of patients with GR-negative tumors (GR-negative group). RESULTS: GR was found in 63 patients (68.5%) with a mean +/- SEM concentration of 26.97 +/- 4.05 fmol/g protein. There were no significant differences in patient clinicopathologic characteristics between GR-positive and GR-negative groups. The 5-year disease-free and actuarial survival rates for GR-positive and GR-negative groups were 21.6% and 44.4% (P =.002) and 57.2% and 83.3% (P =.0003), respectively. After multivariate analysis was performed, GR positivity was found to be an independent prognostic factor of disease-free and actuarial survival after liver resection for HCC. CONCLUSIONS: The GR can be found in the cytosol of most HCCs and is an independent prognostic factor of HCC after liver resection. Patients with GR-positive HCC have lower survival rates than those with GR-negative HCC.