Keratinocyte growth factor (KGF) from gastric fibroblasts have been reported to stimulate proliferation of scirrhous gastric cancer cells with K-samII amplification in a paracrine manner. The aim of this study was to evaluate the clinical significance of the co-expression of K-sam and KGF in gastric carcinomas. A total of 136 primary gastric tumors were investigated by staining with antibodies against K-sam and KGF. K-sam expression on cancer cells and KGF expression on fibroblasts was estimated. The relationship between the K-sam and/or KGF expression and the clinicopathological characteristics were analyzed. K-sam expression was positive in 42 (31%) of 136 gastric carcinomas. K-sam expression was positively correlated with scirrhous cancer (p<0.001), diffuse type (p=0.031), invasion depth (p=0.018) and infiltration type (p<0.001). Prognosis of K-sam positive patients was significantly poorer than that of K-sam negative patients (p<0.001). The prognosis of patients with both K-sam and KGF positive tumors was significantly worse in comparison to either negative tumors (p<0.001). In 94 patients with a curative resection, a multivariate analysis revealed the co-expression of K-sam and KGF to be an independent prognostic factor (p=0.029). In conclusion, the co-expression of K-sam and KGF in gastric cancer might be a useful prognostic factor.

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