Molecular marker identification for relapse prediction in 5-FU-based adjuvant chemotherapy in gastric and colorectal cancers

PLoS One. 2012;7(8):e43236. doi: 10.1371/journal.pone.0043236. Epub 2012 Aug 14.

Abstract

To confirm the clinical significance of NF-κB and JNK protein expression from experimentally identified candidates for predicting prognosis for patients with 5-FU treatment, we evaluated the protein expression of surgically removed specimens. A total of 79 specimens were obtained from 30 gastric and 49 colorectal cancer patients who underwent R0 resection followed by postoperative 5-FU based adjuvant chemotherapy. Immunohistochemical examinations of NF-κB and JNK on tissue microarrays (TMAs) revealed that significantly shorter time-to-relapse (TTR) in both NF-κB(+) and JNK(-) subgroups in both gastric (NF-κB(+), p = 0.0002, HR11.7. 95%CI3 3.2-43.4; JNK(-), p = 0.0302, HR4.4, 95%CI 1.2-16.6) and colon (NF-κB(+), p = 0.0038, HR36.9, 95%CI 3.2-426.0; JNK(-), p = 0.0098, HR3.2, 95%CI 1.3-7.7) cancers. These protein expression patterns also show strong discriminately power in gastric cancer patients for overall survival rate, suggesting a potential utility as prognostic or chemosensitivity markers. Baseline expression of these proteins using gastric cancer cell lines demonstrated the reciprocal patterns between NF-κB and JNK, while 5-FU exposure of these cell lines only induced NF-κB, suggesting that NF-κB plays a dominant role in the response to 5-FU. Subsequent siRNA experiments confirmed that gene knockdown of NF-κB increased 5-FU-specific sensitivity, whereas that of JNK did not affect the chemosensitivity. These results suggest that the expression of these proteins may aid in the decisions involved with adjuvant chemotherapy for gastrointestinal tract cancers.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antimetabolites, Antineoplastic / pharmacology*
  • Biomarkers, Tumor / metabolism*
  • Cell Line, Tumor
  • Chemotherapy, Adjuvant / methods*
  • Cluster Analysis
  • Colorectal Neoplasms / drug therapy*
  • Colorectal Neoplasms / metabolism
  • Fluorouracil / pharmacology*
  • Gene Expression Regulation, Neoplastic*
  • Humans
  • Immunohistochemistry / methods
  • MAP Kinase Kinase 4 / metabolism
  • Middle Aged
  • Prognosis
  • RNA, Small Interfering / metabolism
  • Recurrence
  • Stomach Neoplasms / drug therapy*
  • Stomach Neoplasms / metabolism

Substances

  • Antimetabolites, Antineoplastic
  • Biomarkers, Tumor
  • RNA, Small Interfering
  • MAP Kinase Kinase 4
  • Fluorouracil

Grants and funding

This work was supported by: Keiryokai Research Foundation (101) by S.S.N.; KAKENHI (21591676); Grant-in-Aid for Scientific Research(C) by S.S.N; and MIAST (Medical Innovation by Advanced Science and Technology) project of the Ministry of Education, Culture, Sports, Science and Technology, JAPAN by S.S.N, K.K, N.U., C.M., T.S., and G.W. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.