Rectum cancers with distant metastases (Stage IV) show decreased tissue expression of E cadherin at the invasive tumor front
Abstract
Aim: Rectal cancers (RC) are one of the most cause of death worldwide. Survival of patients is mainly associated with the TNM stage. However, patients characterized by the same tumor stage often have prominent distinct survival. This is particularly a clinical challenge and new biomarkers are needed. In the present research, we analyzed the prognostic role of E-cadherin (EC) in stage IV RC.
Methods: Eighty-five stage IV RC patients who underwent surgery at Kırıkkale University during 2001–2015 were included in this retrospective study. EC was scored on immunohistochemical (IHC) stained sections with a cut-off value of ≥50% ratio. The relationship between the results and the clinicopathological characteristics was analyzed.
Results: EC percentage was significantly downregulated in RCs classified as advanced pT (p= 0.005), angiolymphatic invasion (p= 0.034), advanced stage (p=0.006), high number of metastatic lymph nodes (p=0.039) and high grade (p=0.014). In univariate analysis, low EC patients had worse 5-year survival (RFS: 28.3%, p<0.001; OS: 41.2%, p<0.001). Multivariate analyzes confirmed that low EC is an independent worse survival parameter for RFS (Hazard ratio [HR]: 1.33 [1.15-3.46], p=0.001) and OS (HR: 1.57 [1.09–4.32], p=0.002).
Conclusions: Our study confirmed the prognostic significance of low EC in stage IV RCs. Therefore, we suggest that this parameter may be an indicator of worse prognosis in RCs. This biomarker can be defined on IHC stained slides readily and can use a molecular agent in RC therapy.
Keywords: E cadherin, rectal cancer, prognostic markers, stage IV
Özet
Amaç: Rektal kanserler (RK) dünya genelinde en önemli ölüm nedenlerinden biridir. Hastaların sağkalımı temel olarak TNM evresi ile ilişkilidir. Bununla birlikte, aynı tümör evresi ile karakterize edilen hastalar sıklıkla belirgin farklı sağ kalımlara sahiptir. Bu özellikle klinik bir çelişkidir ve yüksek riskli hastaları ayırt etmek için yeni biobelirteçlere ihtiyaç vardır. Bu araştırmada, stage IV RK'da E cadherin (EC) 'nin sağ kalımdaki rolünü analiz ettik.
Yöntem: Bu retrospektif çalışmaya Kırıkkale Üniversitesi'nde 2001-2015 arasında cerrahi girişim uygulanan seksen beş RK hastası dahil edildi. EC, immünohistokimyasal (İHK) boyanmış kesitler üzerinde %50 sınır değeri olarak skorlandı. Sonuçlar ve klinikopatolojik özellikler arasındaki ilişki analiz edildi.
Bulgular: EC yüzdesi, ileri pT (p = 0.005), anjiyolenfatik invazyon (p = 0.034), ileri evre (p=0.006), yüksek lenf nodu metastazı sayısı (p=0.039) ve ileri grade (p=0.014) olan RK'larda anlamlı derecede düşüktü. Tek değişkenli analizde, düşük EC’li hastalar 5 yıllık kötü sağkalıma sahipti (RFS:% 28.3, p <0.001; OS:% 41.2, p<0.001). Çok değişkenli analizler, düşük EC'nin RFS (Hazard ratio [HR]: 1.33 [1.15 – 3.46], p = 0.001) ve OS (HR: 1.57 [1.09 – 4.32], p=0.002) için bağımsız bir kötü hayatta kalma parametresi olduğunu doğruladı.
Sonuç: Sonuçlarımız stage IV RK'larda düşük EC' nin prognostik önemini doğruladı. Bu nedenle, bu parametrenin RK'larda kötü prognozun bir göstergesi olabileceğini öneriyoruz. Bu biyobelirteç, İHK boyalı lamlar üzerinde kolaylıkla tanımlanabilir ve RK tedavisinde bir moleküler ajan olarak kullanılabilir.
Anahtar Sözcükler: E cadherin, rektal kanser, prognostik belirteçler, stage IV
Keywords
References
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Details
Primary Language
Turkish
Subjects
-
Journal Section
Research Article
Publication Date
March 31, 2020
Submission Date
May 28, 2019
Acceptance Date
November 24, 2019
Published in Issue
Year 2020 Volume: 53 Number: 1