Expression and Prognostic Values of Id-1 and Id-3 in Gastric Adenocarcinoma

Background Id (inhibitor of differentiation/DNA binding)-1 and -3 are involved in neoangiogenesis; they antagonize basic helix-loop-helix proteins, inhibit differentiation, and enhance cell proliferation. The aim of this study was to investigate Id-1 and -3 expression in gastric tumors and their clinical relevance in gastric cancer. Materials and Methods We investigated Id-1 and Id-3 expression in gastric cancer samples by immunohistochemistry and Western blotting, and further analyzed the relationship between expression of Id-1 and Id-3 and clinicopathologic characteristics. Results Expression of Id-1 and -3 was found significantly more often in gastric cancers than in matched adjacent nonmalignant tissues. Cancer samples with poor or moderate histologic differentiation showed significantly stronger Id-1 and -3 expression than cancer samples with high differentiation. In cancer samples, strong or moderate expression of Id-3, but not Id-1, was a strong independent predictor for shorter overall survival in multivariate analysis. Conclusions The level of Id-1 and -3 protein expression was associated with the malignant potential of gastric tumors. In cancer samples, stronger Id-1 and -3 expression is associated with poor differentiation and more aggressive behavior of tumor cells, resulting in poor clinical outcome. Consequently, Id-3 might be used to independently predict survival of patients with gastric cancer.