Yu Liang, Yongmin Li, Rui Guo, Yan Zhao, Huanshuo Miao, Hong Chang, Yue Chen
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A Kaplan-Meier analysis was used to determine the clinicopathological characteristics significantly correlated with survival, and a Cox proportional hazards analysis was used to identify factors independently affecting overall survival prognosis. Furthermore, the findings were validated by the Gene Expression Omnibus database.</p><p><strong>Results: </strong>Among the 3441 stage II/III colorectal cancer patients, in comparison to patients with neuroendocrine differentiation (+), patients with neuroendocrine differentiation (+) had a poorer prognosis (P = 0.001). Furthermore, multivariate survival analysis of stage II cases revealed that tumor differentiation (P = 0.018), nerve invasion (P < 0.001) and neuroendocrine differentiation (+) (P = 0.002) were independent prognostic factors. Moreover, the prognosis of patients with neuroendocrine differentiation (+) was similar to that of patients with high-risk factors in stage II cases (P = 0.639). 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引用次数: 0
摘要
神经内分泌分化常出现在结直肠癌中，但其对预后的影响仍存在争议。本研究探讨了II/III期结直肠癌患者神经内分泌分化与预后的关系：2012年至2018年间，共纳入3441例II/III期结直肠癌患者进行分析。为验证神经内分泌分化情况，采用免疫组化方法探讨结直肠癌中嗜铬粒蛋白 A 和突触素的表达情况。此外，还分析了组间总生存期的差异。采用卡普兰-梅耶分析确定与生存期显著相关的临床病理特征，并采用考克斯比例危险度分析确定独立影响总生存期预后的因素。此外，研究结果还得到了基因表达总库（Gene Expression Omnibus）数据库的验证：结果：在3441例II/III期结直肠癌患者中，与神经内分泌分化（+）患者相比，神经内分泌分化（+）患者的预后较差（P = 0.001）。此外，对 II 期病例进行的多变量生存分析显示，肿瘤分化（P = 0.018）、神经侵犯（P < 0.001）和神经内分泌分化（+）（P = 0.002）是独立的预后因素。此外，神经内分泌分化（+）患者的预后与二期病例中存在高危因素的患者相似（P = 0.639）。在基因表达总库数据库中，嗜铬粒蛋白 A 的高表达与 II 期结直肠癌患者的不良预后相关（P < 0.001）：神经内分泌分化可能是影响 II 期结直肠癌患者预后的另一个高危因素。
Identification and initial validation of neuroendocrine differentiation as a novel prognostic factor in stage II colorectal cancer patients.
Neuroendocrine differentiation is often found in colorectal cancer but its impact on prognosis remains controversial. This study explored the association between neuroendocrine differentiation and prognosis in stage II/III colorectal cancer patients.
Methods: Between 2012 and 2018, a total of 3,441 stage II/III colorectal cancer patients were included for analysis. To verify neuroendocrine differentiation, immunohistochemistry was performed to explore the expression of chromogranin A and synaptophysin in colorectal cancer. In addition, the difference in overall survival between groups was analyzed. A Kaplan-Meier analysis was used to determine the clinicopathological characteristics significantly correlated with survival, and a Cox proportional hazards analysis was used to identify factors independently affecting overall survival prognosis. Furthermore, the findings were validated by the Gene Expression Omnibus database.
Results: Among the 3441 stage II/III colorectal cancer patients, in comparison to patients with neuroendocrine differentiation (+), patients with neuroendocrine differentiation (+) had a poorer prognosis (P = 0.001). Furthermore, multivariate survival analysis of stage II cases revealed that tumor differentiation (P = 0.018), nerve invasion (P < 0.001) and neuroendocrine differentiation (+) (P = 0.002) were independent prognostic factors. Moreover, the prognosis of patients with neuroendocrine differentiation (+) was similar to that of patients with high-risk factors in stage II cases (P = 0.639). High chromogranin A expression was correlated with poor prognosis in stage II colorectal cancer patients in the Gene Expression Omnibus database (P < 0.001).
Conclusion: The prognosis of colorectal cancer with neuroendocrine differentiation (+) was poor, especially in stage II colorectal cancer patients. neuroendocrine differentiation might be another high-risk factor for the prognosis of stage II colorectal cancer patients.
期刊介绍：
Although laboratory and clinical cancer research need to be closely linked, observations at the basic level often remain removed from medical applications. This journal works to accelerate the translation of experimental results into the clinic, and back again into the laboratory for further investigation. The fundamental purpose of this effort is to advance clinically-relevant knowledge of cancer, and improve the outcome of prevention, diagnosis and treatment of malignant disease. The journal publishes significant clinical studies from cancer programs around the world, along with important translational laboratory findings, mini-reviews (invited and submitted) and in-depth discussions of evolving and controversial topics in the oncology arena. A unique feature of the journal is a new section which focuses on rapid peer-review and subsequent publication of short reports of phase 1 and phase 2 clinical cancer trials, with a goal of insuring that high-quality clinical cancer research quickly enters the public domain, regardless of the trial’s ultimate conclusions regarding efficacy or toxicity.
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