Nes [11], and abnormal PKCa levels are found in many transformed cell lines [14]. PKCa acts as a tumor promoter in some tumors, but it functions as a tumor suppressor in others [13]. PKCa expression and its role in tumorigenesis and tumor progression have been documented in human cancers. PKCa HIF-2��-IN-1 site Overexpression has been reported in prostate carcinoma, endometrial carcinoma, high-grade bladder urothelial carcinoma, and hepatocellular carcinoma. The up- or downregulation of PKCa has been 1655472 described in hematological malignancies [8], and PKCa downregulation has been observed in basal cell carcinoma and colon carcinoma [8,19?1]. One study reported the activation of PKCa in breast cancer [22], whereas other studies have demonstrated the downregulation of PKCa protein in breast cancer [8,13,17].PKCa Protein Overexpression in Gastric CarcinomaTable 2. PKCa Protein Expression in Gastric Carcinoma and its Correlation with Clinicopathological Parameters.Table 3. Uni-Variate Analysis of Prognostic Markers in 215 Patients with Gastric Carcinoma.PKCa overexpression Parameters Negative (case number) Age (years) ,60 ?0 Gender Female Male Tumor size (cm) #5 .5 Tumor location Proximal Distal Histologic type Intestinal type Diffuse type Differentiation Well to moderately Poorly Depth of 317318-84-6 chemical information invasion T1 2 T3 4 Angiolymphatic invasion Absent Present Nodal status N0 N1-3 TNM stage I+II III+IV Distant metastasis Absent Present Local recurrence No Yes 113 14 79 9 0.8526 78 49 70 18 0.0048 46 81 49 39 0.0047 38 89 33 55 0.2453 40 87 40 48 0.0373 27 100 39 49 0.0003 57 70 55 33 0.0110 66 61 71 17 ,0.0001 20 107 17 71 0.4953 55 72 48 40 0.1048 46 81 35 53 0.5971 39 88 13 75 0.0073 Positive (case number)VariablesHazard ratio95 CI*P**P*Age (years) ,60 ?0 Gender Female Male Tumor size (cm) #5 .5 Tumor location Proximal Distal Histologic type Intestinal type Diffuse type Differentiation Well to moderately Poorly Depth of invasion T1 2 T3 4 Angiolymphatic invasion Absent Present Nodal status N0 N1-3 Pathologic stage I+II III+IV Distant metastasis Absent Present Local recurrence No Yes PKCa overexpression Negative Positive 1 0.677 0.444?.032 0.0699 1 3.494 2.117?.766 ,0.0001 1 5.224 3.435?.944 ,0.0001 1 6.147 3.627?0.420 ,0.0001 1 6.281 3.343?1.800 ,0.0001 1 3.813 2.297?.328 ,0.0001 1 6.497 3.262?2.940 ,0.0001 1 1.761 1.183?.620 0.0053 1 1.525 1.023?.274 0.0381 1 0.682 0.417?.114 0.1264 1 3.396 2.163?.333 ,0.0001 1 1.267 0.837?.920 0.2632 1 1.914 1.158?.164 0.*Significance level: P,0.05. doi:10.1371/journal.pone.0056675.t*CI: confidence interval; **Significance level: P,0.05. doi:10.1371/journal.pone.0056675.tPKCa inhibits cell growth in normal intestinal epithelial cells and pancreatic carcinoma [19]. Thus the expression patterns of PKC isoforms differ across different tissues and even within the same tissue [23]. To date, the role of PKCa expression in human cancers is not well understood, but seems to depend on tumor type. PKCa has been hypothesized to play an important role in the carcinogenesis and metastasis of gastrointestinal cancers. PKCaprotein is the most abundant isoform in gastric epithelial cells [10], although the role of PKCa in gastrointestinal tumors is not clear. With regard to intestinal cancer, one study has postulated that PKCa acts as a tumor suppressor [9], but another study has indicated that PKCa may act as both a tumor promoter and tumor suppressor [24]. In colon carcinoma, PKCa overexpression has been correlated with the migratory activity of tumo.Nes [11], and abnormal PKCa levels are found in many transformed cell lines [14]. PKCa acts as a tumor promoter in some tumors, but it functions as a tumor suppressor in others [13]. PKCa expression and its role in tumorigenesis and tumor progression have been documented in human cancers. PKCa overexpression has been reported in prostate carcinoma, endometrial carcinoma, high-grade bladder urothelial carcinoma, and hepatocellular carcinoma. The up- or downregulation of PKCa has been 1655472 described in hematological malignancies [8], and PKCa downregulation has been observed in basal cell carcinoma and colon carcinoma [8,19?1]. One study reported the activation of PKCa in breast cancer [22], whereas other studies have demonstrated the downregulation of PKCa protein in breast cancer [8,13,17].PKCa Protein Overexpression in Gastric CarcinomaTable 2. PKCa Protein Expression in Gastric Carcinoma and its Correlation with Clinicopathological Parameters.Table 3. Uni-Variate Analysis of Prognostic Markers in 215 Patients with Gastric Carcinoma.PKCa overexpression Parameters Negative (case number) Age (years) ,60 ?0 Gender Female Male Tumor size (cm) #5 .5 Tumor location Proximal Distal Histologic type Intestinal type Diffuse type Differentiation Well to moderately Poorly Depth of invasion T1 2 T3 4 Angiolymphatic invasion Absent Present Nodal status N0 N1-3 TNM stage I+II III+IV Distant metastasis Absent Present Local recurrence No Yes 113 14 79 9 0.8526 78 49 70 18 0.0048 46 81 49 39 0.0047 38 89 33 55 0.2453 40 87 40 48 0.0373 27 100 39 49 0.0003 57 70 55 33 0.0110 66 61 71 17 ,0.0001 20 107 17 71 0.4953 55 72 48 40 0.1048 46 81 35 53 0.5971 39 88 13 75 0.0073 Positive (case number)VariablesHazard ratio95 CI*P**P*Age (years) ,60 ?0 Gender Female Male Tumor size (cm) #5 .5 Tumor location Proximal Distal Histologic type Intestinal type Diffuse type Differentiation Well to moderately Poorly Depth of invasion T1 2 T3 4 Angiolymphatic invasion Absent Present Nodal status N0 N1-3 Pathologic stage I+II III+IV Distant metastasis Absent Present Local recurrence No Yes PKCa overexpression Negative Positive 1 0.677 0.444?.032 0.0699 1 3.494 2.117?.766 ,0.0001 1 5.224 3.435?.944 ,0.0001 1 6.147 3.627?0.420 ,0.0001 1 6.281 3.343?1.800 ,0.0001 1 3.813 2.297?.328 ,0.0001 1 6.497 3.262?2.940 ,0.0001 1 1.761 1.183?.620 0.0053 1 1.525 1.023?.274 0.0381 1 0.682 0.417?.114 0.1264 1 3.396 2.163?.333 ,0.0001 1 1.267 0.837?.920 0.2632 1 1.914 1.158?.164 0.*Significance level: P,0.05. doi:10.1371/journal.pone.0056675.t*CI: confidence interval; **Significance level: P,0.05. doi:10.1371/journal.pone.0056675.tPKCa inhibits cell growth in normal intestinal epithelial cells and pancreatic carcinoma [19]. Thus the expression patterns of PKC isoforms differ across different tissues and even within the same tissue [23]. To date, the role of PKCa expression in human cancers is not well understood, but seems to depend on tumor type. PKCa has been hypothesized to play an important role in the carcinogenesis and metastasis of gastrointestinal cancers. PKCaprotein is the most abundant isoform in gastric epithelial cells [10], although the role of PKCa in gastrointestinal tumors is not clear. With regard to intestinal cancer, one study has postulated that PKCa acts as a tumor suppressor [9], but another study has indicated that PKCa may act as both a tumor promoter and tumor suppressor [24]. In colon carcinoma, PKCa overexpression has been correlated with the migratory activity of tumo.