A novel tumor-based epithelial-to-mesenchymal transition score that associates with prognosis and metastasis in patients with stage II/III colorectal cancer

Roseweir, A.K. et al. (2019) A novel tumor-based epithelial-to-mesenchymal transition score that associates with prognosis and metastasis in patients with stage II/III colorectal cancer. International Journal of Cancer, 144(1), pp. 150-159. (doi:10.1002/ijc.31739) (PMID:29992570)

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Abstract

It is increasingly appreciated that host factors within the tumor centre and microenvironment play a key role in dictating colorectal cancer (CRC) outcomes. As a result, the metastatic process has now been defined as a result of epithelial‐mesenchymal transition (EMT). Establishment of the role of EMT within the tumor centre and its effect on the tumor microenvironment would be beneficial for prognosis and therapeutic intervention in CRC. The present study assessed five immunohistochemical EMT markers within the tumor centre on a 185 stage II/III CRC patient TMA. In 185 patients with CRC; cytoplasmic snail (HR 1.94 95% CI 1.15‐3.29, p=0.012), and a novel combined EMT score (HR 3.86 95% CI 2.17‐6.86, p<0.001) were associated with decreased cancer‐specific survival. The combined EMT score was also associated with increased tumor budding (p=0.046), and systemic inflammation (p=0.007), as well as decreased memory T‐cells within the stroma (p=0.030) and at the invasive margin (p=0.035). Furthermore, the combined EMT score was associated with cancer specific survival independent of TNM‐stage (HR 4.12 95% CI 2.30‐7.39, p<0.001). In conclusion, a novel combined EMT score stratifies patient's survival in stage II/III CRC and associates with key factors of tumor metastasis. Therefore, the combined EMT score could be used to identify patients at risk of micrometastases and who may benefit from standard adjuvant therapy, potentially in combination with EMT blockade.

Item Type:Articles
Additional Information:This work was supported by the Royal College of Surgeons of England.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Park, Mr James and Horgan, Professor Paul and Bennett, Miss Lindsay and Roseweir, Dr Antonia and Roxburgh, Dr Campbell and Quinn, Dr Jean and Edwards, Professor Joanne and Powell, Dr Arfon and McMillan, Professor Donald and Kong, Dr Chia Yew and Van Wyk, Dr Hester
Authors: Roseweir, A.K., Kong, C.Y., Park, J.H., Bennett, L., Powell, A.G.M.T., Quinn, J., van Wyk, H.C., Horgan, P.G., McMillan, D.C., Edwards, J., and Roxburgh, C.S.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cancer Sciences
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:International Journal of Cancer
Publisher:Wiley
ISSN:0020-7136
ISSN (Online):1097-0215
Published Online:11 July 2018
Copyright Holders:Copyright © 2018 UICC
First Published:First published in International Journal of Cancer 144(1):150-159
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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