| Theme |
Molecular biology of colorectal tumors |
| Title |
Invasion and metastasis of colorectal cancer |
| Author |
Eiji Shinto |
Department of Surgery, National Defense Medical College |
| Author |
Satomi Fukazawa |
Department of Surgery, National Defense Medical College |
| Author |
Yoshiki Kajiwara |
Department of Surgery, National Defense Medical College |
| Author |
Satsuki Mochizuki |
Department of Surgery, National Defense Medical College |
| Author |
Koichi Okamoto |
Department of Surgery, National Defense Medical College |
| Author |
Masato Yamadera |
Department of Surgery, National Defense Medical College |
| Author |
Hitoshi Tsuda |
Department of Pathology, National Defense Medical College |
| Author |
Hideki Ueno |
Department of Surgery, National Defense Medical College |
| [ Summary ] |
Colorectal cancer cells located at the invasive front of primary tumors exhibit site-specific morphological features (e.g., tumor budding and cytoplasmic podia), as well as molecular indications such as various forms of gene expression associated with epithelial mesenchymal transition (EMT), which represent a potential for invasiveness and metastasis. Their prognostic significance has been repeatedly demonstrated. In our retrospective study of patients with resected pT3 colorectal cancer, it was shown that high-grade budding was associated with unfavorable prognoses as compared to low-grade budding. For example the 5-year overall survival (OS) rate was 59.8 and 87.7 % respectively (P< 0.0001). Similarly, the 5-year OS rate in patients with high-grade cytoplasmic podia (60.5 %) was much lower than those with low-grade cytoplasmic podia (83.8 %; P=0.0003). Additionally, area-specific tissue microarray analysis demonstrated that reduced expression of E-cadherin in cancer cells at the invasive front was an independent prognostic factor (hazard ratio: 2.6, P= 0.0082).
Morphological and molecular features at the invasive front are closely associated with the metastatic potential of individual tumors, which could be useful biomarkers to evaluate tumor aggressiveness in clinical practice. |