RT Journal Article SR Electronic T1 Prognostic significance of PAK4 expression in gastric cancer JF Journal of Clinical Pathology JO J Clin Pathol FD BMJ Publishing Group Ltd and Association of Clinical Pathologists SP 580 OP 585 DO 10.1136/jclinpath-2015-203330 VO 69 IS 7 A1 Kenta Kobayashi A1 Mikito Inokuchi A1 Yoko Takagi A1 Sho Otsuki A1 Yoshitaka Fujimori A1 Yuya Sato A1 Yoshimitsu Yanaka A1 Kyoko Higuchi A1 Tomoki Aburatani A1 Chiharu Tomii A1 Hiroyuki Uetake A1 Kazuyuki Kojima A1 Tatsuyuki Kawano YR 2016 UL http://jcp.bmj.com/content/69/7/580.abstract AB Aims p-21 activated kinase (PAK) 4, part of the six PAK families, plays an important role in growth factor signalling, cytoskeletal remodelling, gene transcription, cell proliferation and oncogenic transformation. However, the clinical significance of PAK4 in gastric cancer has yet to be fully elucidated. PAK4 expression was evaluated, and the correlations of PAK4 expression with clinicopathological features and outcomes in gastric cancer were examined.Methods Gastric adenocarcinomas obtained from 217 patients who underwent gastrectomy were analysed. PAK4 expression was evaluated using immunohistochemical staining.Results PAK4 overexpression was found in 95 (43.8%) of 217 tumours . High PAK4 expression was significantly correlated with clinicopathological variables related to tumour progression, including depth of invasion, metastatic lymph nodes, pathological stage, distant metastasis or recurrent disease. High PAK4 expression was significantly associated with poorer disease-specific survival (DSS) (p<0.001) and relapse-free survival (RFS) (p<0.001). On multivariable analysis, PAK4 was an independent prognostic factor for DSS (HR 2.5 (95% CI 1.4 to 4.7), p=0.003) and RFS (HR 2.8 (95% CI 1.4 to 5.6), p=0.004). Even in stage II and III disease, PAK4 was an independent prognostic factor for RFS (HR 2.2 (95% CI 1.1 to 4.5), p=0.029).Conclusions PAK4 may become a new prognostic factor in patients with gastric cancer.