The Expression of Multiple Proteins as Prognostic Factors in Colorectal Cancer: Cathepsin D, p53, COX-2, Epidermal Growth Factor Receptor, C-erbB-2, and Ki-67

• Published in: Gut and liver Vol. 8; no. 1; pp. 13 - 23
• Main Authors: Hyun Jung Chung, Byoung Wook Bang, Hyung Gil Kim, Kye Sook Kwon, Yong Woon Shin, Seok Jeong, Don Haeng Lee, Shin Goo Park
• Format: Journal Article
• Language: Korean
• Published: 대한소화기기능성질환·운동학회 30.01.2014
• Subjects: Cathepsin D; Colorectal neoplasms; Prognostic factors
• ISSN: 1976-2283

Background/Aims: A single gene mutation alone cannot explain the poor prognosis of colorectal cancer. This study aimed to establish a correlation between the expression of six proteins and the prognosis of colorectal cancer patients. Methods: Tissue samples were collected from 266 patients who underwent surgery for colorectal cancer at our institution from January 2006 to December 2007. The expression of six proteins were determined using immunohistochemical staining of specimens. Results: Cathepsin D, p53, COX-2, epidermal growth factor receptor, c-erbB-2, and Ki-67 expression were detected in 38.7%, 60.9%, 37.6%, 35.7%, 30.1%, and 74.4% of the samples, respectively. The expression of cathepsin D was significantly correlated with reduced cancer-free survival (p=0.036) and colorectal cancer-specific survival (p=0.003), but the other expression levels were not. In a multivariate analysis, cathepsin D expression was found to be an independent prognostic factor for poorer colorectal cancer-specific survival (hazard ratio, 8.55; 95% confidence interval, 1.07 to 68.49). Furthermore, patients with tumors expressing four or more of the proteins had a significantly decreased cancer-free survival rate (p=0.006) and colorectal cancer-specific survival rate (p=0.002). Conclusions: Patients with cathepsin D positivity had a poorer outcome than patients who were cathepsin D-negative. Thus, cathepsin D may provide an indicator for appropriate intensive follow-up and adjuvant chemotherapy. (Gut Liver 2014;8:13-23) Correspondence to: In Kyu Lee Department of Surgery, Yeouido St. Mary`s Hospital, The Catholic University of Korea College of Medicine, 10 63-ro, Yeongdeungpo-gu, Seoul 150-713, Korea Tel: +82-2-3779-2235, Fax: +82-2-786-0802, E-mail: cmcgslee@catholic.ac.kr Received on September 13, 2012. Revised on December 23, 2012. Accepted on March 13, 2013. Published online on August 14, 2013. pISSN 1976-2283 eISSN 2005-1212 http://dx.doi.org/10.5009/gnl.2014.8.1.13 Il Yong Shin and Na Young Sung contributed equally to this work as first authors. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.