Background and objective: Besides current clinicopathologic staging system extensively used in clinic, more information of molecular staging is need for more accurate staging of colorectal cancer (CRC). This study was to evaluate the prognostic value of metastasis-related tumor markers in CRC.
Methods: The expression of CD44v6, matrix matalloproteinase-2 (MMP-2), cyclooxygenase-2 (COX-2), epidermal growth factor (EGF), epidermal growth factor receptor (EGFR) and vascular epidermal growth factor (VEGF) in a tissue microarray containing 95 specimens of CRC were detected by immunohistochemistry (IHC). The correlations of these tumor markers to the prognosis of CRC patients were analyzed.
Results: In patients with Dukes' A/B disease, the 5-year recurrence rates were significantly higher in CD44v6-, EGF-and EGFR-positive groups than in negative groups (30.9% vs. 8.3%,P=0.045; 38.1% vs. 8.8%, P=0.022; 27.5% vs. 11.8%, P=0.047, respectively). In patients with Dukes' C disease, the 5-year recurrence rates were significantly higher in MMP-2-, COX-2-and VEGF-positive group than in negative groups (73.3% vs. 37.5%, P=0.045; 69.2% vs. 25.0%, P=0.017; 62.5% vs. 25.0%, P=0.03, respectively). In patients with Dukes' A/B disease, there were a significantly higher 5-year recurrence rate and a lower 5-year survival rate in those with more than three positive markers than in those with 1-3 positive markers (P=0.019, P=0.03). However, there was no significant difference in patients with Dukes' C disease in such condition.
Conclusions: Over-expression of CD44v6, EGF and EGFR are related to poor prognosis of Dukes' A/B CRC, while over-expression of MMP-2, COX-2 and VEGF are related to poor prognosis of Dukes' C CRC. For patients with Dukes' A/B CRC, the more positive markers, the higher 5-year recurrence rate and the poorer 5-year survival.