Loss of the coxsackie and
adenovirus receptor (CAR) has previously been observed in
gastric cancer. The role of CAR in
gastric cancer pathobiology, however, is unclear. We therefore analysed CAR in 196 R(0)-resected gastric
adenocarcinomas and non-cancerous gastric mucosa samples using immunohistochemistry and immunofluorescence. Coxsackie and
adenovirus receptor was found at the surface and foveolar epithelium of all non-neoplastic gastric mucosa samples (n=175), whereas only 56% of
gastric cancer specimens showed CAR positivity (P<0.0001). Loss of CAR correlated significantly with decreased differentiation, increased infiltrative depths, presence of distant
metastases, and was also associated with reduced
carcinoma-specific survival. To clarify whether CAR impacts the tumorbiologic properties of
gastric cancer, we subsequently determined the role of CAR in proliferation, migration, and invasion of
gastric cancer cell lines by application of specific CAR
siRNA or ectopic expression of a human full-length CAR
cDNA. These experiments showed that RNAi-mediated CAR knock down resulted in increased proliferation, migration, and invasion of
gastric cancer cell lines, whereas enforced ectopic CAR expression led to opposite effects. We conclude that the association of reduced presence of CAR in more severe disease states, together with our findings in
gastric cancer cell lines, suggests that CAR functionally contributes to
gastric cancer pathogenesis, showing features of a tumour suppressor.