Klotho _ LRP-6 _ Gastric Adenocarcinoma

NCT05293535 | Unknown

• 1 other identifier: Klotho _ LRP-6 _ GC
• Study Type: observational
• Target: 45
• Locations: 0 countries
• Sites: N/A

Brief Summary

Gastric cancer is the fifth most common malignancy in the world after cancers of the lung, breast, colorectum, and prostate. Gastric cancer is the third leading cause of cancer death and is responsible for 723,000 deaths yearly. Gastric carcinoma (GC) is a multifactorial disease which is difficult to diagnose in early-stage because of a time lag between the onset of growth and the appearance of clinical presentation. So, its prognosis is poor as evidenced by the 5-year survival rate. Klotho is anti-aging gene encoding a protein with multiple pleiotropic effect. Cancer and ageing share comparable principles. Klotho gene has been described as a tumor suppressor gene in numerous solid tumors and hematological malignancies. Klotho expression has been shown to be significantly down-regulated in malignant tissue compared to adjacent non-malignant tissue with good prognosis in cancers with high Klotho expression, including colorectal, pancreatic, gastric, esophageal, breast, hepatocellular, ovarian, and renal carcinomas. In contrast, a recent study documented that Klotho negative invasive duct carcinoma group exhibited good prognosis than the Klotho positive group regarding the disease- free survival after the surgical resection in breast cancer patient. Lipoprotein receptor- related protein 6 (LRP6) is a type I single transmembrane protein which is a member of the low-density lipoprotein receptor (LDLR) gene family of receptors that is highly conserved among species. In 2000, LRP6 was identified as a co-receptor for Wnt and Frizzled (FZD) to transduce Wnt/β-catenin signaling. Dysregulation of LRP6 is involved in cancer. LRP6 is highly expressed in several cancer cell lines and overexpression of LRP6 promotes cancer cell proliferation. LRP6 expression is frequently upregulated in breast cancer tissue, and respective overexpression or knockdown of LRP6 induces or inhibits breast tumorigenesis. LRP6 is highly expressed in tumors of liver cancer patients, and overexpression of LRP6 promotes liver cancer cell proliferation and tumor growth. In prostate cancer, high expression levels of LRP6 are detected which activate Wnt/β-catenin signaling and glycolysis through Akt signaling. The end result is increased prostate cancer cell proliferation. The mechanism of Klotho-mediated Wnt inhibition was as a result of Klotho binding to Wnt ligands, namely Wnt3A and Wnt5A; thereby impeding binding of these ligands to their cell surface receptor.

Conditions

Gastric Adenocarcinoma; Klotho; LRP-6

Outcome Measures

Primary Outcomes (1)

• Expression of Klotho and LRP-6 proteins in gastric adenocarcinoma

  Expression of Klotho and LRP-6 proteins in gastric adenocarcinoma via immunohistochemistry.

  1-2 years

Study Arms (2)

Klotho

Evaluate the expression of Klotho in gastric adenocarcinoma via immunohistochemistry, find the association between the expression of Klotho in gastric adenocarcinoma and demographic patient data, and clinicopathologic parameters of the patients and investigate the effect of Klotho expression on the prognosis of gastric adenocarcinoma. Correlate between the Klotho and LRP-6 protein expression.

Other: Prognostic study

LRP-6

Evaluate the expression of LRP-6 protein in gastric adenocarcinoma via immunohistochemistry, find the association between the expression of LRP-6 protein in gastric adenocarcinoma and demographic patient data, and clinicopathologic parameters of the patients and investigate the effect of LRP-6 protein expression on the prognosis of gastric adenocarcinoma. Correlate between the Klotho and LRP-6 protein expression.

Other: Prognostic study

Interventions

Prognostic study OTHER

No intervention... as it is a prognostic study and no intervention done on patients.

Klotho; LRP-6

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study is retrospective cohort study of 40-50 cases of gastric adenocarcinoma in our South Egypt Cancer Institute in the period from 2016 to 2020.

You may qualify if:

• Patients had a pathological diagnosis of gastric adenocarcinoma.
• Staging, lymph node (LN) metastasis and overall survival (OS) were analyzed according to Klotho and LRP-6 expression status.

You may not qualify if:

• Gastric Tumors other than adenocarcinoma.
• Cases with loss records files.

Sponsors & Collaborators

• Assiut University: lead
• South Egypt Cancer Institute: collaborator

Related Publications (18)

• Wong MCS, Huang J, Chan PSF, Choi P, Lao XQ, Chan SM, Teoh A, Liang P. Global Incidence and Mortality of Gastric Cancer, 1980-2018. JAMA Netw Open. 2021 Jul 1;4(7):e2118457. doi: 10.1001/jamanetworkopen.2021.18457.

  PMID: 34309666 BACKGROUND

• Dermaku-Sopjani M, Kolgeci S, Abazi S, Sopjani M. Significance of the anti-aging protein Klotho. Mol Membr Biol. 2013 Dec;30(8):369-85. doi: 10.3109/09687688.2013.837518. Epub 2013 Oct 14.

  PMID: 24124751 BACKGROUND

• Zhou X, Fang X, Jiang Y, Geng L, Li X, Li Y, Lu K, Li P, Lv X, Wang X. Klotho, an anti-aging gene, acts as a tumor suppressor and inhibitor of IGF-1R signaling in diffuse large B cell lymphoma. J Hematol Oncol. 2017 Feb 2;10(1):37. doi: 10.1186/s13045-017-0391-5.

  PMID: 28153033 BACKGROUND

• Li XX, Huang LY, Peng JJ, Liang L, Shi DB, Zheng HT, Cai SJ. Klotho suppresses growth and invasion of colon cancer cells through inhibition of IGF1R-mediated PI3K/AKT pathway. Int J Oncol. 2014 Aug;45(2):611-8. doi: 10.3892/ijo.2014.2430. Epub 2014 May 9.

  PMID: 24818842 BACKGROUND

• Jiang B, Gu Y, Chen Y. Identification of novel predictive markers for the prognosis of pancreatic ductal adenocarcinoma. Cancer Invest. 2014 Jul;32(6):218-25. doi: 10.3109/07357907.2014.905586. Epub 2014 Apr 18.

  PMID: 24745611 BACKGROUND

• Wang L, Wang X, Wang X, Jie P, Lu H, Zhang S, Lin X, Lam EK, Cui Y, Yu J, Jin H. Klotho is silenced through promoter hypermethylation in gastric cancer. Am J Cancer Res. 2011;1(1):111-119. Epub 2010 Nov 10.

  PMID: 21969138 BACKGROUND

• Tang X, Fan Z, Wang Y, Ji G, Wang M, Lin J, Huang S. Expression of klotho and beta-catenin in esophageal squamous cell carcinoma, and their clinicopathological and prognostic significance. Dis Esophagus. 2016 Apr;29(3):207-14. doi: 10.1111/dote.12289. Epub 2014 Oct 6.

  PMID: 25287007 BACKGROUND

• Wolf I, Levanon-Cohen S, Bose S, Ligumsky H, Sredni B, Kanety H, Kuro-o M, Karlan B, Kaufman B, Koeffler HP, Rubinek T. Klotho: a tumor suppressor and a modulator of the IGF-1 and FGF pathways in human breast cancer. Oncogene. 2008 Nov 27;27(56):7094-105. doi: 10.1038/onc.2008.292. Epub 2008 Sep 1.

  PMID: 18762812 BACKGROUND

• Tang X, Wang Y, Fan Z, Ji G, Wang M, Lin J, Huang S, Meltzer SJ. Klotho: a tumor suppressor and modulator of the Wnt/beta-catenin pathway in human hepatocellular carcinoma. Lab Invest. 2016 Feb;96(2):197-205. doi: 10.1038/labinvest.2015.86. Epub 2015 Aug 3.

  PMID: 26237271 BACKGROUND

• Yan Y, Wang Y, Xiong Y, Lin X, Zhou P, Chen Z. Reduced Klotho expression contributes to poor survival rates in human patients with ovarian cancer, and overexpression of Klotho inhibits the progression of ovarian cancer partly via the inhibition of systemic inflammation in nude mice. Mol Med Rep. 2017 Apr;15(4):1777-1785. doi: 10.3892/mmr.2017.6172. Epub 2017 Feb 7.

  PMID: 28259911 BACKGROUND

• Gigante M, Lucarelli G, Divella C, Netti GS, Pontrelli P, Cafiero C, Grandaliano G, Castellano G, Rutigliano M, Stallone G, Bettocchi C, Ditonno P, Gesualdo L, Battaglia M, Ranieri E. Soluble Serum alphaKlotho Is a Potential Predictive Marker of Disease Progression in Clear Cell Renal Cell Carcinoma. Medicine (Baltimore). 2015 Nov;94(45):e1917. doi: 10.1097/MD.0000000000001917.

  PMID: 26559258 BACKGROUND

• Suzuki S, Sakurai K, Hirano T, Adachi K, Koshinaga T, Makishima M. [Prediction of Prognosis in Breast Carcinoma Using Klotho Immunohistochemistry]. Gan To Kagaku Ryoho. 2021 Aug;48(8):1043-1047. Japanese.

  PMID: 34404073 BACKGROUND

• Jeong W, Jho EH. Regulation of the Low-Density Lipoprotein Receptor-Related Protein LRP6 and Its Association With Disease: Wnt/beta-Catenin Signaling and Beyond. Front Cell Dev Biol. 2021 Sep 13;9:714330. doi: 10.3389/fcell.2021.714330. eCollection 2021.

  PMID: 34589484 BACKGROUND

• Zhang J, Li Y, Liu Q, Lu W, Bu G. Wnt signaling activation and mammary gland hyperplasia in MMTV-LRP6 transgenic mice: implication for breast cancer tumorigenesis. Oncogene. 2010 Jan 28;29(4):539-49. doi: 10.1038/onc.2009.339. Epub 2009 Nov 2.

  PMID: 19881541 BACKGROUND

• Tung EK, Wong BY, Yau TO, Ng IO. Upregulation of the Wnt co-receptor LRP6 promotes hepatocarcinogenesis and enhances cell invasion. PLoS One. 2012;7(5):e36565. doi: 10.1371/journal.pone.0036565. Epub 2012 May 3.

  PMID: 22570728 BACKGROUND

• Lemieux E, Cagnol S, Beaudry K, Carrier J, Rivard N. Oncogenic KRAS signalling promotes the Wnt/beta-catenin pathway through LRP6 in colorectal cancer. Oncogene. 2015 Sep 17;34(38):4914-27. doi: 10.1038/onc.2014.416. Epub 2014 Dec 15.

  PMID: 25500543 BACKGROUND

• Tahir SA, Yang G, Goltsov A, Song KD, Ren C, Wang J, Chang W, Thompson TC. Caveolin-1-LRP6 signaling module stimulates aerobic glycolysis in prostate cancer. Cancer Res. 2013 Mar 15;73(6):1900-11. doi: 10.1158/0008-5472.CAN-12-3040. Epub 2013 Jan 9.

  PMID: 23302227 BACKGROUND

• Liu H, Fergusson MM, Castilho RM, Liu J, Cao L, Chen J, Malide D, Rovira II, Schimel D, Kuo CJ, Gutkind JS, Hwang PM, Finkel T. Augmented Wnt signaling in a mammalian model of accelerated aging. Science. 2007 Aug 10;317(5839):803-6. doi: 10.1126/science.1143578.

  PMID: 17690294 BACKGROUND

Central Study Contacts

Marina Bassem Youssef Kostandy, MBBCh

CONTACT

01276628554; marina.bassem@yahoo.com

Marwa Tammam Amin Hammam, Doctorate

CONTACT

01111186049; marwat.hussien@aun.edu.eg

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Demonstator at Oncologic Pathology Department, South Egypt Cancer Institute, Assiut University

Study Record Dates

• First Submitted: March 11, 2022
• First Posted: March 24, 2022
• Study Start: April 1, 2023
• Primary Completion: April 1, 2024
• Study Completion: April 1, 2024
• Last Updated: January 31, 2023

Record last verified: 2023-01