INTESTINE Vol.22 No.5(5)

Theme Molecular biology of colorectal tumors
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.
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