Prognostic significance of Cytokeratin 20-positive lymph node vascular endothelial growth factor A mRNA and chromodomain helicase DNA binding protein 4 in pN0 colorectal cancer patients
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Sze Chuen Cesar Wong1, Moon Tong Cheung2, Lewis Lai Yin Luk2, Vivian Ha Man Lee2, Pak Tat Chan2, Hin Fung Andy Tsang1, Evelyn Yin Kwan Wong1, Vivian Weiwen Xue1, Amanda Kit Ching Chan3 and John Kwok Cheung Chan3
1Department of Health Technology and Informatics, Hong Kong Polytechnic University, Hong Kong, China
2Department of Surgery, Queen Elizabeth Hospital, Hong Kong, China
3Department of Pathology, Queen Elizabeth Hospital, Hong Kong, China
Sze Chuen Cesar Wong, email: firstname.lastname@example.org
Keywords: prognostic significance; cytokeratin 20 lymph node; vascular endothelial growth factor A mRNA; chromodomain helicase DNA binding protein 4 mRNA
Received: May 05, 2017 Accepted: November 28, 2017 Published: December 19, 2017
BACKGROUND: Cytokeratin 20-positive cells in lymph nodes from pN0 colorectal cancer (CRC) patients were detected previously by us. The aims of this study were to investigate which tumor metastasis-related genes were involved and their potential clinical significance.
RESULTS: Fourteen of 84 (17%) genes were differentially expressed by at least 2-fold. Among them, 10 genes were up-regulated whereas 4 genes were down-regulated. Those differential expressed genes were validated in the second cohort of specimens. Follow-up analysis for 60 months showed that patients with lymph node vascular endothelial growth factor A (VEGF-A) mRNA and chromodomain helicase DNA binding protein 4 (CHD4) mRNA expression higher than the median copies had significantly shorter time to recurrence than those with lower than the median copies. Multivariate analysis showed that VEGF-A mRNA, CHD4 mRNA and lymphatic vessel involvement were independent prognostic factors for disease recurrence.
CONCLUSIONS: VEGF-A mRNA and CHD4 mRNA were up-regulated in CK20-positive pN0 lymph nodes and they may have prognostic significance in pN0 CRC patients.
METHODS: Two cohorts of lymph node specimens from pN0 CRC patients of each with and without CK20-positive cells were recruited. In the first cohort, tumor metastasis genes were profiled using gene expression arrays. Differential expressed genes were validated in the second cohort. Moreover, their prognostic significance was examined by following-up the second cohort of patients with CK20-positive cells for 60 months and all histopathological findings were correlated to recurrence.
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