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Objective To investigate the expression of heparanase-2 (HPSE2) in gastric cancer tissues, and explore its effect on the survival and prognosis of the cancer and invasion and migration of the cancer cells. Methods Immunohistochemical staining of HPSE2 was performed on gastric cancer tissue chip to examine the expression level of HPSE2 in gastric cancer and paracancerous tissues. The correlation of HPSE2 expression level with clinical features, survival, prognosis and prognostic factors were analyzed. The lentival vectors of HPSE2 overexpression were constructed, and then transfected in gastric cancer cell lines SGC7901 and MKN28. The effect of HPSE2 overexpression on invasion and migration of gastric cancer cells were detected using Transwell analysis. Results The mean pathological score of HPSE2 was 4.56 in gastric cancer tissue, and 7.18 in paracancer tissues, showing that the expression was significantly lower in gastric cancer than paracancer tissues (P < 0.05). The expression level of HPSE2 was closely correlated with the tumor size, lymph node metastasis, and clinical staging. The patients with higher HPSE2 expression had obviously shorter median survival time and cumulative survival rate than those with lower expression (P < 0.05). Cox proportional risk model showed that clinical stage, tumor size and HPSE2 protein expression were risk factors for prognosis of gastric cancer patients (P < 0.05). Overexpression of HPSE2 could remarkably inhibit the invasion and migration of gastric cancer cells. Conclusion HPSE2 is lowly expressed in gastric cancer tissues, and is associated with the tumor size, lymph node metastasis, survival and prognosis of gastric cancer. Overexpression of HPSE2 could inhibit the invasion and migration of gastric cancer cells.

We report that gastric cancer patients exhibiting high levels of heparanase 2 (Hpa2) survive longer. Similarly, mice administrated with gastric carcinoma cells engineered to overexpress Hpa2 produced smaller tumors and survived longer than mice administrated with control cells. These beneficial effects were found to associate with increased phosphorylation of AMP-activated protein kinase (AMPK) that play an instrumental role in cell metabolism and is situated at the center of a tumor suppressor network. We also found that MG132, an inhibitor of the proteasome that results in proteotoxic stress, prominently enhances Hpa2 expression. Notably, Hpa2 induction by MG132 appeared to be mediated by AMPK, thus establishing a loop that feeds itself where Hpa2 enhances AMPK phosphorylation that, in turn, induces Hpa2 expression, possibly leading to attenuation of gastric tumorigenesis. Heparanase is highly implicated in tumor metastasis due to its capacity to cleave heparan sulfate and, consequently, remodel the extracellular matrix underlying epithelial and endothelial cells. In striking contrast, only little attention was given to its close homolog, heparanase 2 (Hpa2), possibly because it lacks heparan sulfate-degrading activity typical of heparanase. We subjected sections of gastric carcinoma to immunostaining and correlated Hpa2 immunoreactivity with clinical records, including tumor grade, stage and patients' status. We over-expressed Hpa2 in gastric carcinoma cell lines and examined their tumorigenic properties in vitro and in vivo. We also evaluated the expression of Hpa2 by gastric carcinoma cells following inhibition of the proteasome, leading to proteotoxic stress, and the resulting signaling responsible for Hpa2 gene regulation. Here, we report that gastric cancer patients exhibiting high levels of Hpa2 survive longer. Similarly, mice administrated with gastric carcinoma cells engineered to over-express Hpa2 produced smaller tumors and survived longer than mice administrated with control cells. This was associated with increased phosphorylation of AMP-activated protein kinase (AMPK), a kinase that is situated at the center of a tumor suppressor network. We also found that MG132, an inhibitor of the proteasome that results in proteotoxic stress, prominently enhances Hpa2 expression. Notably, Hpa2 induction by MG132 appeared to be mediated by AMPK, and AMPK was found to induce the expression of Hpa2, thus establishing a loop that feeds itself where Hpa2 enhances AMPK phosphorylation that, in turn, induces Hpa2 expression, leading to attenuation of gastric tumorigenesis. These results indicate that high levels of Hpa2 in some tumors are due to stress conditions that tumors often experience due to their high rates of cell proliferation and high metabolic demands. This increase in Hpa2 levels by the stressed tumors appears critically important for patient outcomes. [ABSTRACT FROM AUTHOR]

• Protective autophagy induced by DDP decreases chemosensitivity in GC cells. • MGMT inhibited ATG4B to repress autophagy. • Inhibition of autophagy enhanced the chemosensitivity to DDP in GC xenograft model. • High MGMT expression and low ATG4B expression are significantly correlated with survival of GC. Cisplatin (DDP) is the first-line drug for the treatment of gastric cancer (GC). However, DDP resistance is common. Autophagy, which is closely related to chemoresistance, is a process of resolving and recycling proteins and damaged cellular organs. Additionally, O-6-methylguanine-DNA methyltransferase (MGMT) is responsible for alkylating drug resistance. However, the relationship between autophagy and MGMT in response to DDP in GC is still unknown. In the present study, we determined that autophagy induced by DDP decreases chemosensitivity in GC cell lines. DDP may have induced autophagy in GC by inhibiting MGMT to increase autophagy-related gene (ATG) 4B. Inhibition of MGMT-mediated ATG4B suppression resulted in autophagy induction and DDP resistance. In vivo , combined DDP and autophagy inhibitor chloroquine (CQ) enhanced the anti-tumor effect of DDP; additionally, the negative correlation of MGMT and ATG4B was confirmed. High expression of MGMT and low expression of ATG4B were significantly correlated with favorable five-year survival rate (P < 0.05) in 66 clinicopathologically characterized GC cases. Our study demonstrate that DDP inhibits MGMT-mediated autophagy suppression to decrease chemosensitivity in GC, which provides a novel therapeutic strategy to promote DDP chemosensitivity in GC. [ABSTRACT FROM AUTHOR]