Multivariate analysis indicated that only the peritoneal dissemination was an independent prognostic factor on patient’s survival (p = 0.001; Table 4). Table 4 Multivariate analysis for 100 patients with gastric cancer. Variable B SE Exp (B) p value Histological type 0.394 0.552 1.482 0.476 Peritoneal dissemination 1.700 0.465 5.474 0.001 AdipoR1 expression 0.718 0.447 2.051 0.108 Discussion Adiponectin, which belongs to the complement 1q family, is composed of an N-terminal

collagen-like sequence and a C-terminal globular region, is well studied in the field of oncology, and its expression is inversely related to weight gain [31]. Ishikawa et al. reported that a low serum VX-809 order Adiponectin level was associated with an increased risk of gastric cancer, although BMI did not differ significantly [23]. In our study, we were also unable to detected significant differences with respect to serum adiponectin levels and Verteporfin mouse BIBF 1120 molecular weight BMI. However, visceral fat predominantly correlates with serum adiponectin levels [32], and BMI cannot be used to distinguish fat distribution (for example, subcutaneous fat versus visceral fat); this may be the reason for the failure to find a significant correlation between the 2 parameters. In addition, a correlation was not observed between the amounts of serum adiponectin and clinicopathological factors or prognosis in gastric cancer. Ishikawa et al. indicated a tendency of an inverse correlation between tumor stage and serum adiponectin

levels, but significant C-X-C chemokine receptor type 7 (CXCR-7) difference was not demonstrated in the current study. With respect to clinicopathological factors, there were significant differences in adiponectin levels according to tumor location and differentiation [23]. Seker et al. also reported significant difference between degrees of tumor differentiations and adiponectin levels [33]. Gastric

cancer patients tend to be cachexic with the progression of primary disease, and this can result in high serum adiponectin levels [34]. Consequently, it is difficult to elucidate the clinicopathological significance of adiponectin in gastroenterological cancer patients because of the aforementioned contradictory relationship [35]. As a result of this lack of significant difference between the clinicopathological factors and serum adiponectin levels, it is presumed that serum adiponectin levels do not contribute to prolonged survival in gastric cancer patients. Generally, it is expected that receptor expression is more important than the amount of serum ligand, but no studies have addressed serum adiponectin and receptor expression levels. Moreover, the expression of adiponectin receptors in gastric cancer cell lines has already been reported [28]. They also demonstrated that the inhibitory effects of adiponectin via AdipoR1 and AdipoR2 using specifically down-regulated experiments by siRNA. In their study, siRNA of adipoR1 strongly abolished the effects of adiponectin, although the effect of siRNA of adipoR2 was less prominent.