Expression of guanylyl cyclase C in tissue samples and the circulation of rectal cancer patients
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Yong Liu1,3, Guoping Cheng2, Jun Qian1, HaiXing Ju1, YuPing Zhu1, Meucci Stefano3, Ulrich Keilholz3 and DeChuan Li1
1Surgical Department of Colorectal Cancer, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province, China
2Pathology Department, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province, China
3Charité Comprehensive Cancer Center, Berlin, Germany
Yong Liu, email: [email protected]
Keywords: guanylyl cyclase C, rectal cancer, tumor metastasis, disease free survival, overall survival
Received: December 10, 2016 Accepted: February 17, 2017 Published: March 21, 2017
Guanylyl cyclase C (GCC) is a transmembrane surface receptor restricted to intestinal epithelial cells, from the duodenum to the rectum. We compared GCC expression in tumors and normal rectal tissues, and investigated the relation between GCC expression and metastasis and long-term survival of rectal cancer patients. Based on the UICC classification, 42 rectal cancer patients in this study were classified as stage I, 48 patients as stage II, and 90 patients as stage III. Overexpression of GCC was observed in 80 rectal tumors as compared to matched normal tissues, where no strong staining of GCC was observed. An association between GCC mRNA in the circulation and tumor emboli in vessels, CK20 mRNA, distant organ metastasis, and survival status was observed in 100 rectal cancer patients. Univariate Cox regression analysis indicated that tumor emboli in vessels, lymph node metastasis, mesenteric root lymph node metastasis and GCC mRNA correlated with 5-year disease-free survival (DFS); while lymph node metastasis, GCC mRNA, and CK20 mRNA strongly correlated with 5-year overall survival (OS). In a multivariate Cox regression model, GCC mRNA level and mesenteric root lymph node metastasis associated with DFS, while GCC mRNA levels associated with OS. Quantification of GCC expression in circulation is a valuable biomarker for assessing tumor burden and predicting outcome in rectal cancer patients.
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