The expression of SOX9, Tiam1, and PTEN is correlated with angiogenesis and prognosis in gastric cancer

BACKGROUND: With a high rate of metastasis and recurrence, gastric cancer (GC), a common malignant tumor, often has a poor prognosis. GC tissues have abnormal expressions of the Sry-related HMG-box family of transcription factors (SOX9), T-lymphoma invasion and metastasis-inducing factor 1 (Tiam1), and phosphatase and tensin homolog deleted on chromosome ten (PTEN). Meanwhile, vascular endothelial growth factor (VEGF) have been reported to play an important role in tumor angiogenesis. This study aimed to analyze the correlation of SOX9, Tiam1, and PTEN with angiogenesis and prognosis in GC. METHODS: A total of 90 patients who underwent GC surgery at our hospital between January 2017 and October 2018 were enrolled. The expressions of SOX9, Tiam1, PTEN, and VEGF in GC tissues and adjacent normal tissues were detected by immunohistochemistry and the differences were analyzed. Spearman’s correlation coefficient was applied to analyze the relationship between the expression levels of SOX9, Tiam1, PTEN, and VEGF. The patients were followed-up. RESULTS: The positive expression rates of SOX9, Tiam1, PTEN, and VEGF in GC tissues were 75.56%, 61.11%, 52.22%, and 48.89%, respectively, compared with 6.67%, 4.44%, 97.78%, and 2.22%, respectively, in the adjacent normal tissues (P<0.05). Spearman’s correlation analysis showed that the expression of SOX9 (r=0.349, P=0.001) and Tiam1 (Tiam1: r=0.370, P=0.000) in GC tissues was positively correlated with VEGF expression; however, PTEN was negatively correlated with VEGF (r=−0.311, P=0.000). There were no significant differences in SOX9, Tiam1, or PTEN expression in GC tissues from patients of different genders or ages (P>0.05). When the tumor was low differentiated, with lymph node metastasis or high TNM staging, the positive expression rates of SOX9 and Tiam1 were significantly increased (P<0.05), while the positive expression rate of PTEN was significantly decreased (P<0.05). The log-rank test results showed that the three-year survival rates of the groups with positive SOX9 (54.41%) and Tiam1 expression (49.09%) were significantly lower than those of the groups with negative SOX9 and Tiam1 expression (77.27% and 77.13%, respectively; P<0.05). The 3-year survival rate in the PTEN positive expression group was significantly higher than that of the PTEN negative expression group (76.60% vs. 41.80%; P<0.05). CONCLUSIONS: SOX9 and Tiam1 are highly expressed, in GC tissues while there is a low expression of PTEN. The expression levels of SOX9, Tiam1, and PTEN are all linearly correlated with VEGF expression, and they have important effects on angiogenesis and is closely related to the three-year survival rate of patients with GC.