Predictive value of APAF-1 and COX-2 expression in pathologic complete response to neoadjuvant chemoradiotherapy for patients with locally advanced rectal adenocarcinoma
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Haihua Peng1,5,*, Kaiyun You2,6,*, Rong Zhang3,*, Shaoyan Xi4, Tian Zhang1, Jun Dong1, Muyan Cai4, Chengtao Wang1, Huizhong Zhang4, Tongchong Zhou5, Yuanhong Gao2, Bixiu Wen1
1Department of Radiation Oncology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
2Department of Radiation Oncology, SunYat-Sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Guangzhou 510060, China
3Department of Endoscopy and Laser, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
4Department of Pathology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
5Department of Radiation Oncology, Cancer Center of Guangzhou Medical University, Guangzhou 510075, China
6Department of Radiation Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
*These authors have contributed equally to this work
Bixiu Wen, email: firstname.lastname@example.org
Yuanhong Gao, email: email@example.com
Keywords: rectal adenocarcinoma, neoadjuvant chemoradiotherapy, complete pathological response, APAF-1, COX-2
Received: November 11, 2015 Accepted: March 28, 2016 Published: May 2, 2016
Purpose: To investigate predictive value of APAF-1 and COX-2 expression in pathologic complete response (pCR) for patients with rectal adenocarcinoma (RAC) who were treated with neoadjuvant chemoradiotherapy (neo-CRT) followed by total mesorectal excision (TME).
Materials and Methods: Immunohistochemistry assay was used to detect expression of APAF-1 and COX-2 in paraffin-wax embedded tissues obtained before neo-CRT for patients with RAC. A 5-point tumor-regression grade (TRG) based on the ratio of residual tumor to fibrosis according to Dworak’s scoring system was used to assess neo-CRT response. The relationship between expression of APAF-1 and COX-2 genes and pCR was explored.
Results: pCR (TRG4) was observed in 23 patients (28.0%). pCR were more likely to be achieved for those with APAF-1 over-expression or lower expression of COX-2. pCR rate in patients with combination of high APAF-1 and low COX-2 expression was 56.0%, significantly higher than those with other combination of APAF1 and COX-2 expression. Multivariate analysis showed that over-expression of APAF-1 and suppressed expression of COX-2 were independent predictive factors for pCR.
Conclusion: Immunohistochemical evaluation of APAF-1 and COX-2 expression on pretreatment specimen may be used to predict pCR to neo-CRT in patients with RAC. The potential of the markers in monitoring pCR patient merits further investigation.
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