Increased LEF1 Expression and Decreased Notch2 Expression Are Strong Predictors of Poor Outcomes in Colorectal Cancer Patients

Background/Objective. We aimed to examine the expression of lymphoid enhancer factor 1 (LEF1) and Notch2 in colorectal cancer (CRC) and their association with clinicopathologic variables and CRC patients'' prognosis. Methods. Immunohistochemistry, quantitative real-time polymerase chain reaction (qRT-PCR), and Western blot analysis were performed to assess the expression of LEF1 and Notch2 in 184 patients with CRC. Results. We observed a strong negative correlation between LEF1 expression and Notch2 expression (P < 0.001). Both LEF1 mRNA and protein expression increased while the Notch2 mRNA and protein expression decreased in tumor specimens compared with the matched paratumorous normal tissue (P < 0.001). An increase in LEF1 protein expression was significantly associated with lymph node metastases, distant metastasis, advanced TNM (tumor-node-metastasis) stage, and shorter overall survival. A decrease in Notch2 protein expression was associated with poorly differentiated tumors, lymph node metastases, distant metastasis, advanced TNM stage, and shorter overall survival of patients. In the multivariate Cox regression analysis, the LEF1 protein expression (P < 0.001), Notch2 protein expression (P < 0.001), TNM stage (P < 0.001), and the combination of increased LEF1 protein coexpression and decreased Notch2 protein coexpression (P < 0.001) were found to be independent prognostic indicators in CRC. Conclusion. Our results suggest that increased LEF1 coexpression and decreased Notch2 coexpression represent a risk factor for poor overall survival of CRC patients.     

Association between KIAA1199 overexpression and tumor invasion,TNM stage,and poor prognosis in colorectal cancer

To investigate the expression of KIAA1199 in tumor tissue and its potential value as a prognostic indicator of survival in patients with colorectal cancer (CRC). The expression of KIAA1199 mRNA in CRC was characterized using real-time PCR and 20 pairs of fresh-frozen CRC tissues and corresponding non-cancerous tissues. KIAA1199 protein expression was confirmed using immunohistochemistry on a tissue microarray chip from 202 patients with CRC. Then, we correlated KIAA1199 protein expression to CRC conventional clinicopathological features and patient’s outcome. The expression of KIAA1199 mRNA and protein were up-regulated in CRC compared to normal tissues (P = 0.015 and P < 0.001, individually). KIAA1199 protein expression was related to tumor invasion depth (P = 0.013) and lymph node metastasis (P = 0.003). Kaplan-Meier survival and Cox regression analyses revealed that high KIAA1199 expression (P < 0.001) and serum carcinoembryonic antigen (CEA) level post operation (P = 0.005) were independent factors predicting poor prognosis of patients with CRC. We present evidence that high expression of KIAA1199 is associated with tumor invasion depth, TNM stage, and poor prognosis in CRC. Our findings suggest KIAA1199 could be used as a prognostic factor and novel therapeutic target for CRC.     

Axl and prostasin are biomarkers for prognosis of ovarian adenocarcinoma

In this study, the protein levels of Axl and prostasin in malignant neoplasms of the ovary and their clinicopathologic significance were investigated. The protein levels of Axl and prostasin in ovarian adenocarcinomas (n = 80), serous cystadenoma (n = 15), mucinous cystadenomas (n = 15), and normal ovary tissues (n = 10) were measured using immunohistochemistry. The percentage of Axl-positive cases was significantly higher in ovarian adenocarcinoma (61.3%) than in mucinous adenoma tissues (13.3%; P < .001) and normal tissues (0.0%; P = .000). The percentage of prostasin-positive cases was significantly lower in ovarian adenocarcinoma (42.5%) than in mucinous adenoma tissues (86.7%; P = .000) and normal tissues (100%; P = .000). The expression of Axl was significantly lower in cases with G1 tumor and TNM stage I or II tumor with no lymph node metastasis than in cases with G3 tumor and TNM stage III or IV tumor with lymph node metastasis (P < .05 or P < .01). However, the expression pattern of prostasin was opposite to that of Axl (P < .01 or P < .01). Univariate Kaplan-Meier analysis showed a negative correlation between Axl expression (P = .000) and overall survival and a positive correlation between prostasin expression (P = .000) and overall survival. Multivariate Cox regression analysis showed that Axl-positive expression and prostasin-negative expression are independent bad prognostic predictors in ovarian adenocarcinoma. Our study suggested that Axl and prostasin expression may be closely related to carcinogenesis, metastasis, and prognosis of ovarian adenocarcinoma.     

Lemur tyrosine kinase-3 is a significant prognostic marker for patients with colorectal cancer

Lemur tyrosine kinase-3 (LMTK3) belongs to the family of serine-threonine-tyrosine kinases and the aberrant expression of LMTK3 was observed in several human malignancies. However, the association of LMTK3 with clinical outcomes in colorectal cancer patients is unclear. Thus, this present study was to evaluate the association of LMTK3 expression level with clinicopathologic factors and prognosis of patients with colorectal cancer (CRC). The expression level of LMTK3 in 69 archival paraffin-embedded colorectal tumor tissue specimens was examined by immunohistochemistry (IHC). As a result, we found that the LMTK3 expression level was significantly elevated in CRC tissues as compared with Crohn’s disease or colorectal polyp tissues (P<0.0001, P<0.0001, respectively). Positive LMTK3 signals in the colorectal cancer cells were observed in about 89.9% (62 of 69) CRC tissue specimens. Additionally, LMTK3 expression was significantly correlated with lymph node metastasis and tumor-node-metastasis (TNM) classification (P=0.003, and P=0.008, respectively), but not with sex, age, tumor location, histological differentiation, tumor size, or depth of tumor invasion (all P>0.05). Kaplan-Meier survival curves showed that the overall survival rate was significantly higher in the patients with low expression of LMTK3 when compared with those patients with high LMTK3 (P=0.010). Moreover, multivariate analysis revealed that LMTK3 expression was an independent prognostic factor for CRC patients (P=0.047). These results suggest that LMTK3 protein could serve as a prognostic marker for CRC patients.     

Prognostic factors of primary pulmonary mucoepidermoid carcinoma: a clinical and pathological analysis of 34 cases

Pulmonary mucoepidermoid carcinoma (PMEC) is a rare malignant neoplasm, and little is known about the prognostic factors. The aim of the present study was to identify the relationship between tumor’s histological features and clinical behaviors and to analyze the survival of patients with PMEC. A total of 34 patients with PMEC from May 2001 to April 2013 were included in the investigation. The clinical data, radiological manifestation, pathological findings, treatment strategy, and prognoses of all patients were analyzed retrospectively. The patients were classified into low-grade group (n = 25) and high-grade group (n = 9), based on histological grades. High-grade PMEC was more common in patient with elevated serum carcinoembryonic antigen (CEA) (P = 0.033), advanced tumor-node-metastasis (TNM) stage (P = 0.004) and lymph node metastasis (P < 0.001). The 5-year PFS and OS of all patients were 75.7% and 83.6%, respectively. Age, pathological grade, lymph node metastasis and TNM stage were correlated with the survival of PMEC patients. Lymph node metastasis was an independent predictor of OS (HR, 0.080; P = 0.029) and PFS (HR, 0.090; P = 0. 004). A higher tumor histological grade indicated a more aggressive behavior. Patients who had undergone complete resection for PMEC without any lymph node metastasis were expected to be cured.     

Over-expression of lncRNA DANCR is associated with advanced tumor progression and poor prognosis in patients with colorectal cancer

Despite advances made in the diagnosis and treatment of human colorectal cancer (CRC), the long-term survival for CRC remains poor. Long non-coding RNA anti-differentiation ncRNA (lncRNA DANCR) was identified to be involved in carcinogenesis of hepatocellular carcinoma. While its expression in CRC and potential role in tumor progression is still unknown. In the present study, we investigated the expression level of lncRNA DANCR as well as its association with CRC progression and prognosis. The expression of lncRNA DANCR was detected by quantitative real-time PCR (qRT-PCR) in 104 CRC specimens. The prognostic value of lncRNA DANCR was further analysis. Our results showed that lncRNA DANCR expression was increased in CRC tissues compared with that in adjacent normal tissues (P<0.05). In addition, tumors with high lncRNA DANCR expression was correlated with TNM stage, histologic grade, and lymph node metastasis (P<0.05). Kaplan-Meier analysis showed that patients with high lncRNA DANCR expression had a shorter overall survival (OS) and disease-free survival (DFS) compared with the low lncRNA DANCR expression group (P<0.05). Moreover, in a multivariate Cox model, our results showed that lncRNA DANCR expression was an independent poor prognostic factor for both OS and DFS in CRC. Our data indicated that lncRNA DANCR expression might be a novel potential biomarker for CRC prognosis.     

Mixed Carcinoma as an Independent Prognostic Factor in Submucosal Invasive Gastric Carcinoma

Mixed carcinoma shows a mixture of glandular and signet ring/poorly cohesive cellular histological components and the prognostic significance of each component is not fully understood. This study aimed to investigate the significance of the poorly cohesive cellular histological component as a risk factor for lymph node metastasis and to examine the diagnostic reliability of endoscopic biopsy. Clinicopathologic characteristics of 202 patients who underwent submucosal invasive gastric carcinoma resection with lymph node dissection in 2005–2012 were reviewed. Mixed carcinoma accounted for 27.2% (56/202) of cases. The overall prevalence of lymph node metastasis was 17.3% (35/202). Lymphatic invasion (P < 0.001), family history of carcinoma (P = 0.025), tumor size (P = 0.004), Lauren classification (P = 0.042), and presence of any poorly cohesive cellular histological component (P = 0.021) positively correlated with the lymph node metastasis rate on univariate analysis. Multivariate analyses revealed lymphatic invasion, family history of any carcinoma, and the presence of any poorly cohesive cellular histological component to be significant and independent factors related to lymph node metastasis. Review of preoperative biopsy slides showed that preoperative biopsy demonstrated a sensitivity of 63.6% and a specificity of 100% in detecting the presence of the poorly cohesive cellular histological component, compared with gastrectomy specimens. The presence of any poorly cohesive cellular histological component was an independent risk factor associated with lymph node metastasis in submucosal invasive gastric carcinoma. Endoscopic biopsy had limited value in predicting the presence and proportion of the poorly cohesive cellular histologic component due to the heterogeneity of mixed carcinoma.     

Intra-tumoral budding in preoperative biopsy specimens predicts lymph node and distant metastasis in patients with colorectal cancer

Tumor budding, a histological hallmark of epithelial-mesenchymal transition in colorectal cancer, is a parameter of tumor progression and according to the International Union Against Cancer/American Joint Committee on Cancer an 'additional' prognostic factor. The current definition of tumor budding is reserved for the invasive tumor front of colorectal cancer (so called peri-tumoral budding), but tumor buds can also be observed in small preoperative biopsy specimens. Whereas the prognostic value of peri-tumoral budding assessed in resection specimens has found wide acceptance, the value of budding in preoperative biopsies, which normally do not encompass the invasive tumor margin and hence can be called intra-tumoral budding, has not been systematically investigated yet. Therefore, the aim of this study is to assess the predictive value of intra-tumoral budding for lymph node and distant metastasis in preoperative biopsies. Preoperative biopsy samples and consecutive resection specimens from 72 patients with pathological information on TNM stage, vascular, lymphatic and perineural invasion, and tumor border configuration were used to evaluate intra-tumoral budding and peri-tumoral budding. Both parameters were scored semiquantitatively as 'high' (detectable at low power magnification × 2.5) and 'low' (occasional budding at intermediate magnification × 10, difficult to find or absent). In biopsy samples high intra-tumoral budding was observed in 12/72 patients (17%) and associated with high peri-tumoral budding in the corresponding resection specimens (P=0.008). Additionally, there was a correlation between high intra-tumoral budding and lymph node metastasis (P=0.034), distant metastasis (P=0.007) and higher tumor grade (P=0.025). Peri-tumoral budding was associated with higher N stage (P=0.004), vascular (P=0.046) and lymphatic invasion (P=0.019) as well as with an infiltrating tumor border (P<0.001), reflecting the predictive power of peri-tumoral budding for tumor progression. High intra-tumoral budding in preoperative biopsy samples of colorectal cancer patients predicts high peri-tumoral budding at the invasive margin and lymph node metastasis in the corresponding resection specimens as well as distant metastasis.     

EGFR和Ki-67在肠癌组织中的表达及临床意义

目的:探讨表皮生长因子受体(epidermal growth factor receptor,EGFR)和Ki-67在结直肠癌(colorectal cancer,CRC)组织中的表达及临床意义.方法:应用免疫组织化学染色检测100例CRC组织中EGFR和Ki-67蛋白的表达,并分析其与临床病理特征的关系.结果:EGFR,Ki-67在CRC中的阳性表达率分别为70.0％,85.0％.EGFR的阳性表达在结直肠癌的不同分化程度和TNM分期中差异有统计学意义(P＜0.05),与淋巴结转移呈正相关(P＜0.05).Ki-67的表达与结直肠癌组织分化程度、淋巴结转移和肿瘤原发部位有关(P＜0.05).在CRC组织中,Ki-67与EGFR蛋白呈显著正相关(r=0.581,P＜0.001).结论:EGFR和Ki-67蛋白的表达与组织分化程度及淋巴结转移密切相关,二者的联合检测有助于结直肠癌恶性程度的判断和预后的估计.     

利用TCGA数据库分析miR-196b在结直肠癌患者中的临床表达特征并探索miR-196b的体外抗5-FU作用

目的:研究微小RNA(miR)-196b在结直肠癌患者中的表达及其临床意义,探讨过表达miR-196b的结直肠癌细胞对5-氟尿嘧啶(5-FU)的敏感性。方法:在癌症基因组图谱(The Cancer Genome Atlas,TCGA)公共数据库下载结直肠癌患者miRNA测序数据及其对应的临床病理资料,运用SPSS 17.0分析miR-196b在结直肠癌患者中的表达水平以及临床特征;采用瞬时转染的方法在人结直肠癌HCT116细胞中过表达miR-196b,并用MTS法分析过表达miR-196b的细胞对5-FU药物敏感性的变化。结果:miR-196b高表达与结直肠癌患者淋巴结转移及TNM分期相关(P0.05),与年龄和性别等无相关性。淋巴结转移和远处转移是直肠癌患者生存的独立影响因子(P0.05),miR-196b的表达水平与患者生存状况无关。过表达miR-196b的HCT116细胞在不同浓度的5-FU作用下,细胞存活率均明显高于对照组(P0.05)。结论:miR-196b可能是结直肠癌患者肿瘤分期和淋巴结转移的分子标志物,并可降低结直肠癌细胞对5-FU的敏感性。     

Size and histologic characteristics of lymph node material retrieved from tissue discarded after routine pathologic examination of lung cancer resection specimens

Redissection of discarded lung resection specimens after routine pathology examination reveals missed lymph node metastasis. We sought to determine if size can be used to grossly select lymph nodes for microscopic examination. This is a prospective cohort study of lymph nodes retrieved from discarded lung resection specimens. The association between size and histologic characteristics of retrieved material was compared by the Wilcoxon-Mann-Whitney test. We retrieved 1094 grossly ‘lymph node–like” tissue from 112 remnant lung resection specimens, of which 345 (32%) proved not to be lymph nodes and 71 (9%) of 749 lymph nodes had metastasis. Metastasis was present in discarded nodes in 26 (23%) of 112 patients. The non–lymph node tissue was significantly smaller than lymph nodes (P < .0001); lymph nodes with metastases were significantly larger than those without metastases (P < .0001). However, there was significant size overlap between the 3 types of grossly lymph node–like tissue. Thirty-two percent of nodes with metastasis were less than 1 cm; 15% of patients had at least 1 lymph node less than 1 cm with metastasis. The size difference between lymph nodes with and without metastasis is clinically unhelpful because of broad overlap. Size is insufficiently discriminatory and cannot be relied on to select materials for histologic examination. A third of grossly retrieved material was non–lymph node tissue. This probably occurs during routine pathologic examination and likely contributes to the low N1 lymph node count.     

Overexpression of FXYD-3 Is Involved in the Tumorigenesis and Development of Esophageal Squamous Cell Carcinoma

Objective. To investigate the association of FXYD-3 expression with clinicopathological variables and PINCH in patients with ESCC. Patients and Methods. Expression of FXYD-3 protein was immunohistochemically examined in normal esophageal mucous (n = 20) and ESCC (n = 64). Results. Expression of FXYD-3 in the cytoplasm markedly increased from normal esophageal epithelial cells to primary ESCC (P = 0.001). The expression of FXYD-3 was correlated with TNM stages and depth of tumor invasion. Furthermore, the cases with lymph node metastasis tended to show a higher frequency of positive expression than those without metastasis (P = 0.086), and FXYD-3 expression tended to be positively related to the expression of PINCH (P = 0.063). Moreover, the cases positive for both proteins had the highest frequency of lymph node metastasis (P = 0.001). However, FXYD-3 expression was not correlated with patient''s gender (P = 0.847), age (P = 0.876), tumor location (P = 0.279), size (P = 0.771), grade of differentiation (P = 0.279), and survival (P = 0.113). Conclusion. Overexpression of FXYD-3 in the cytoplasm may play an important role in the tumorigenesis and development in the human ESCC, particularly in combination with PINCH expression.     

Potential role of plasmacytoid dendritic cells for FOXP3 regulatory T cell development in human colorectal cancer and tumor draining lymph node

FOXP3⁺ regulatory T cells (Tregs) play an important role in the maintenance of tumor immunity tolerance. Compared with conventional myeloid dentritic cells (mDCs), plasmacytoid dendritic cells (pDCs) exhibit poor immunostimulatory ability, and their interaction with T cells often promotes the development of Tregs. The aim of this study was to determine FOXP3⁺ Tregs and CD123⁺pDCs infiltration in colorectal cancer and tumor draining lymph node (TDLN), and to evaluate the clinical significance and relationship between pDCs infiltration and Tregs development in the CRC tolerogenic milieu. An immunohistochemical assay was conducted to assess FOXP3⁺Tregs and CD123⁺pDCs infiltration in tumor tissue and in metastatic-free TDLN (mfTDLN) and metastatic TDLN (mTDLN). The results showed that FOXP3⁺ Tregs infiltration was more frequent in tumor tissue than in adjacent normal mucosa (P < 0.001). FOXP3⁺Tregs infiltration was associated with advanced TNM stage and lymph node metastasis (P < 0.01 and P < 0.01 for TNM stage and lymph node metastasis, respectively). Different from FOXP3⁺Tregs, CD123⁺pDCs frequencies were lower in most CRC tumor tissues, whereas the positive rate of CD123 expression in CRC was significantly higher than in adjacent normal mucosa tissue (P < 0.01). Compared to mfTDLN, mTDLN was significantly enriched in FOXP3⁺ Tregs (P < 0.01) and increased in pDC/mDC ratio (P < 0.01). The statistical analysis demonstrated a significant correlation in both Tregs and pDC/mDC ratio in mTDLN. These results suggest that there are more FOXP3⁺ Tregs with a stronger prognostic significance which might promote tumor tolerance, and that CD123⁺pDCs might contribute to Tregs development in the CRC tolerogenic milieu.     

人食管鳞癌组织中RhoC和Ki-67的表达及意义

 目的：检测人食管鳞癌组织中RhoC和Ki-67的表达,探讨它们在食管鳞癌发生发展中的作用及相关性。方法：采用免疫组织化学方法（二步法）,检测分析52例人食管鳞癌组织中RhoC和Ki-67蛋白的表达情况及其与患者临床病理特征的关系。结果：（1）食管鳞癌组织RhoC蛋白的阳性表达率为61.5%（32/52）,相应癌旁组织RhoC阳性表达率为29.7%（11/37）,差异显著（P＜0.05）。（2）RhoC表达与食管鳞癌临床TNM分期和淋巴结转移密切相关,TNM Ⅲ期食管鳞癌组织中RhoC阳性表达率为78.3%（18/23）,显著高于TNM Ⅰ～Ⅱ期的48.3%（14/29）（P＜0.05）;伴有淋巴结转移的食管鳞癌组织中RhoC阳性表达率为81.8%（18/22）,显著高于无淋巴结转移的46.7%（14/30）（P＜0.05）。（3）食管鳞癌组织中,RhoC与Ki-67的表达呈显著正相关（r=0.322,P＜0.05）,均呈升高趋势。结论：RhoC的高表达与食管鳞癌的分期、淋巴结转移及细胞增殖密切相关。RhoC可成为食管鳞癌早期诊断和判断预后的辅助指标。     

A four actin-binding protein signature model for poor prognosis of patients with esophageal squamous cell carcinoma

The actin cytoskeleton is a dynamic structure with actin-binding proteins (ABPs) playing an essential role in the regulation of migration, differentiation and signal transduction in all eukaryotic cells. We examined the relationship between altered expression of four ABPs and clinical parameters in esophageal squamous cell carcinoma (ESCC). To this end, we analyzed 152 formalin-fixed and paraffin-embedded esophageal curative resection specimens by immunohistochemistry for tensin, profilin-1, villin-1 and talin. A molecular predictor model, based on the combined expression of the four proteins, was developed to correlate the expression pattern of the four ABPs with clinical factors and prognosis of ESCC. According to the results, weak significance was found for tensin in lymph node metastasis (P=0.033), and profilin-1 in pTNM stage (P=0.031). However, our four-protein model showed strong correlation with the 5-year overall survival rate (P=0.002). Similarly, Kendall’s tau-b test also showed the relationship between the collective expression pattern of the four ABPs with lymph node metastasis (P=0.005) and pTNM stage (P=0.001). Our results demonstrate that the collective protein expression pattern of four actin-binding proteins could be a biomarker to estimate the prognosis of ESCC patients.     

Expression and clinical significances of Beclin1, LC3 and mTOR in colorectal cancer

Autophagy is related to cancer and other diseases, and compromised autophagy could promote chromosome instability associated with carcinogenesis and tumor progression. The role of autophagy in the growth and metastasis of colorectal cancer (CRC) remains poorly understood. Beclin1 mediates autophagic initiation, and LC3 is a specific marker for autophagy. Inactivation of mTOR caused by cellular hypoxia or energy deficiency induces autophagic activity. This study aims to examine the expression and clinical significance of these proteins in CRC. Immunohistochemistry results showed that the positive expression rates of Beclin1, LC3, and mTOR in cancer tissues were 90.50%, 87.19%, and 46.28%, respectively, which were higher than those in adjacent tissues (P < 0.05). Differentiation degree and lymph node metastasis were associated with LC3 overexpression (P < 0.05) but not with Beclin1 (P > 0.05). Lymph node metastasis was also related to mTOR. Spearman analysis results showed that LC3 expression was positively correlated with Beclin1 but negatively correlated with mTOR (r = 0.593 and -0.165, respectively; P < 0.01). Beclin1 expression was also not associated with mTOR (P > 0.05). Survival analysis further indicated that LC3, mTOR, and lymph node metastasis were independent prognostic factors in CRC. Real-time PCR results and Western blot indicated that Beclin1, LC3, and mTOR expression in CRC was significantly higher than that in adjacent tissues (P < 0.01). The aberrant protein expression may be associated with the development and progression of CRC. The LC3 and mTOR genes must be simultaneously detected to evaluate progression and prognosis of CRC.