Rectum cancers with distant metastases (Stage IV) show decreased tissue expression of E cadherin at the invasive tumor front

Year 2020, , 12 - 19, 31.03.2020

Mehmet Zengin , Pınar Atasoy

https://doi.org/10.20492/aeahtd.571124

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

E cadherin, rectal cancer, prognostic markers

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