Theme | Molecular biology of colorectal tumors | |
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Title | Invasion and metastasis of colorectal cancer | |
Publish Date | 2018/09 | |
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. |