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Cheng K, Chen H, Chen B, Li J, Fan C, Yan H, Huang W, Zhao T, Luo Y, Peng L. Hsa_circ_0101050 accelerates the progression of Colon cancer by targeting the miR-140-3 p/MELK axis. Transl Oncol 2024; 44:101890. [PMID: 38579527 PMCID: PMC11004704 DOI: 10.1016/j.tranon.2024.101890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/09/2023] [Accepted: 01/22/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Circular RNAs (circRNAs) are involved in the progression of colon cancer (CC). This study aimed to examine the role of a new circRNA circ_0101050 in CC. METHODS Dual-luciferase reporter and RNA immunoprecipitation analyses were performed to validate the target relationships among maternal embryonic leucine zipper kinase (MELK), microRNA (miR)-140-3 p, and circ_0101050. Expression levels were calculated using western blotting and/or quantitative reverse transcription-polymerase chain reaction (qRT-PCR). Western blotting was performed to evaluate the relative expression of Bcl-2 and Bax proteins to determine cell death. Cell Counting Kit-8 (CCK-8) and colony formation assays were performed to determine the proliferative potential of CC cells. The migration rate of CC cells was evaluated using wound healing assays. Tumor formation tests were performed to determine the effect of circ_0101050 on tumor development in vivo. RESULTS Elevated levels of circ_0101050 and MELK were observed in CC. By inhibiting circ 0,101,050 or MELK, CC cell proliferation and migration were inhibited, but CC cell apoptosis was promoted. Silencing circ_0101050 also inhibited CC growth in vivo. We also found that miR-140-3 p was downregulated, which alleviated the repressive effects of circ_0101050 knockdown on proliferating and migrating CC cells, as well as the stimulating effect on apoptosis. In addition, the absence of MELK alleviated the effects of miR-140-3 p downregulation, which enhanced CC cell malignancy. CONCLUSIONS Circ_0101050 exacerbates malignant phenotypes in CC by targeting the miR-140-3 p/MELK axis. These findings suggested that the circ_0101050/miR-140-3 p/MELK network may be a prospective target for CC treatment.
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Affiliation(s)
- Kuoju Cheng
- Department of Clinical Pharmacy, Dazhou integrated TCM & Western Medicine Hospital, Dazhou 635000, Sichuan, PR China
| | - Hao Chen
- Department of Gastroenterology, Dazhou integrated TCM & Western Medicine Hospital, Dazhou 635000, Sichuan, PR China
| | - Bin Chen
- Department of Gastroenterology, Dazhou integrated TCM & Western Medicine Hospital, Dazhou 635000, Sichuan, PR China
| | - Jing Li
- Department of Gastroenterology, Dazhou integrated TCM & Western Medicine Hospital, Dazhou 635000, Sichuan, PR China
| | - Caibo Fan
- Department of Gastroenterology, Dazhou integrated TCM & Western Medicine Hospital, Dazhou 635000, Sichuan, PR China
| | - Huan Yan
- Department of Gastroenterology, Dazhou integrated TCM & Western Medicine Hospital, Dazhou 635000, Sichuan, PR China
| | - Wei Huang
- Department of Gastroenterology, Dazhou integrated TCM & Western Medicine Hospital, Dazhou 635000, Sichuan, PR China
| | - Ting Zhao
- Department of Gastroenterology, Dazhou integrated TCM & Western Medicine Hospital, Dazhou 635000, Sichuan, PR China
| | - Yun Luo
- Department of Gastroenterology, Dazhou integrated TCM & Western Medicine Hospital, Dazhou 635000, Sichuan, PR China
| | - Lei Peng
- Department of Gastroenterology, Dazhou integrated TCM & Western Medicine Hospital, Dazhou 635000, Sichuan, PR China.
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Gwenzi T, Schrotz-King P, Anker SC, Schöttker B, Hoffmeister M, Brenner H. Post-operative C-reactive protein as a strong independent predictor of long-term colorectal cancer outcomes: consistent findings from two large patient cohorts. ESMO Open 2024; 9:102982. [PMID: 38613909 PMCID: PMC11033061 DOI: 10.1016/j.esmoop.2024.102982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/05/2024] [Accepted: 03/04/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND Post-surgery blood-based biomarkers may be useful for guiding treatment and surveillance decisions among colorectal cancer (CRC) patients. However, most candidate biomarkers provide little if any predictive value beyond stage at diagnosis. We aimed to investigate the independent prognostic value of post-operative serum C-reactive protein (CRP), a highly sensitive biomarker of inflammation, for long-term CRC outcomes in two large patient cohorts. MATERIALS AND METHODS CRP levels were measured from serum samples of CRC patients collected ≥1 month post-surgery in the German DACHS (n = 1416) and the UK Biobank (n = 1149) cohorts. Associations of post-operative CRP with overall survival (OS) and CRC-specific survival (CSS) were assessed using Cox regression and presented as hazard ratios (HRs) with 95% confidence intervals (CIs), adjusted for key sociodemographic and clinical covariates. RESULTS In both cohorts, consistent strong dose-response relationships between post-operative CRP and both OS and CSS were observed. Adjusted HRs (95% CI) for CRP >10 versus <3 mg/l were 1.93 (1.58-2.35) and 2.70 (2.03-3.59) in the DACHS cohort, and 2.70 (1.96-3.71) and 2.61 (1.83-3.72) in the UK Biobank cohort, respectively. Associations between post-operative CRP and OS were particularly strong among younger patients (<65 years at diagnosis; P value for interaction by age <0.01). CONCLUSIONS Serum CRP determined a month or more after surgery may be useful as a strong independent prognostic biomarker for guiding therapeutic decisions and for surveillance of the course of disease of CRC patients, particularly those <65 years of age at diagnosis.
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Affiliation(s)
- T Gwenzi
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg; Medical Faculty Heidelberg, Heidelberg University, Heidelberg
| | - P Schrotz-King
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg
| | - S C Anker
- Department of Internal Medicine, University Hospital Heidelberg, Heidelberg
| | - B Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg; Network Aging Research, Heidelberg University, Heidelberg
| | - M Hoffmeister
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg
| | - H Brenner
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg; Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg; Network Aging Research, Heidelberg University, Heidelberg; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.
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Lv Y, Zheng P, Mao Y, Xu Y, Chang W, Lin Q, Ji M, Ye L, Tang W, Xu J. Intratumor APOL3 delineates a distinctive immunogenic ferroptosis subset with prognosis prediction in colorectal cancer. Cancer Sci 2024; 115:257-269. [PMID: 37986654 PMCID: PMC10823281 DOI: 10.1111/cas.16009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/12/2023] [Accepted: 10/24/2023] [Indexed: 11/22/2023] Open
Abstract
With the essential role of lipid transporting signaling in cancer-related immunity, apolipoprotein L3 (APOL3), a member of the apolipoprotein L gene family, demonstrated significant modulation ability in immunity. However, the expression profile and critical role of APOL3 in colorectal cancer (CRC) remain unclear. This study aimed to investigate the prognostic significance of APOL3 expression and its biological predictive value in CRC. The study enrolled multiple cohorts, consisting of 911 tumor microarray specimens of CRC patients from Zhongshan Hospital, 412 transcriptional data from The Cancer Genome Atlas, and 30 single-cell RNA sequencing (scRNA-seq) from internal and external CRC patients. APOL3 mRNA expression was directly acquired from public datasets, and APOL3 protein expression was detected using immunohistochemistry. Finally, the associations of APOL3 expression with clinical outcomes, immune context, and genomic and ferroptotic features were analyzed. Low APOL3 expression predicted poor prognosis and inferior responsiveness to 5-fluorouracil-based adjuvant chemotherapy (ACT) and targeted therapy. APOL3 fosters an immune-active microenvironment characterized by the promotion of ferroptosis, downregulation of macrophages, and upregulation of CD8+ T cell infiltration. Moreover, the expression of APOL3 in CD8+ T cells is intrinsically linked to ferroptosis and immune activation in CRC. In summary, APOL3 serves as an independent prognosticator and predictive biomarker for immunogenic ferroptosis, ACT, and targeted therapy in CRC. Furthermore, the APOL3 signaling activator could be a novel agent alone or in combination with current therapeutic strategies for CRC.
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Affiliation(s)
- Yang Lv
- Department of Colorectal Surgery, Zhongshan HospitalFudan UniversityShanghaiChina
- Cancer Center, Zhongshan HospitalFudan UniversityShanghaiChina
| | - Peng Zheng
- Department of Colorectal Surgery, Zhongshan HospitalFudan UniversityShanghaiChina
- Cancer Center, Zhongshan HospitalFudan UniversityShanghaiChina
- Shanghai Engineering Research Center of Colorectal Cancer Minimally Invasive SurgeryShanghaiChina
| | - Yihao Mao
- Department of Colorectal Surgery, Zhongshan HospitalFudan UniversityShanghaiChina
- Cancer Center, Zhongshan HospitalFudan UniversityShanghaiChina
- Shanghai Engineering Research Center of Colorectal Cancer Minimally Invasive SurgeryShanghaiChina
| | - Yuqiu Xu
- Department of Colorectal Surgery, Zhongshan HospitalFudan UniversityShanghaiChina
- Cancer Center, Zhongshan HospitalFudan UniversityShanghaiChina
- Shanghai Engineering Research Center of Colorectal Cancer Minimally Invasive SurgeryShanghaiChina
| | - Wenju Chang
- Department of Colorectal Surgery, Zhongshan HospitalFudan UniversityShanghaiChina
- Cancer Center, Zhongshan HospitalFudan UniversityShanghaiChina
- Shanghai Engineering Research Center of Colorectal Cancer Minimally Invasive SurgeryShanghaiChina
| | - Qi Lin
- Department of Colorectal Surgery, Zhongshan HospitalFudan UniversityShanghaiChina
- Cancer Center, Zhongshan HospitalFudan UniversityShanghaiChina
- Shanghai Engineering Research Center of Colorectal Cancer Minimally Invasive SurgeryShanghaiChina
| | - Meiling Ji
- Department of Colorectal Surgery, Zhongshan HospitalFudan UniversityShanghaiChina
- Cancer Center, Zhongshan HospitalFudan UniversityShanghaiChina
- Shanghai Engineering Research Center of Colorectal Cancer Minimally Invasive SurgeryShanghaiChina
| | - Lechi Ye
- Department of Colorectal Surgery, Zhongshan HospitalFudan UniversityShanghaiChina
| | - Wentao Tang
- Department of Colorectal Surgery, Zhongshan HospitalFudan UniversityShanghaiChina
- Cancer Center, Zhongshan HospitalFudan UniversityShanghaiChina
- Shanghai Engineering Research Center of Colorectal Cancer Minimally Invasive SurgeryShanghaiChina
| | - Jianmin Xu
- Department of Colorectal Surgery, Zhongshan HospitalFudan UniversityShanghaiChina
- Cancer Center, Zhongshan HospitalFudan UniversityShanghaiChina
- Shanghai Engineering Research Center of Colorectal Cancer Minimally Invasive SurgeryShanghaiChina
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Jeon J, Lee DB, Shin SJ, Han DH, Chang JS, Han YD, Kim H, Lim JS, Kim HS, Ahn JB. Effect of High-Versus Low-Frequency of Abdominopelvic Computed Tomography Follow-Up Testing on Overall Survival in Patients With Stage II Or III Colon Cancer. Clin Colorectal Cancer 2023; 22:307-317. [PMID: 37271592 DOI: 10.1016/j.clcc.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/06/2023] [Accepted: 05/08/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Intensive surveillance of colon cancer by using the abdominopelvic computed tomography (AP-CT) is common in real world practice; however, it is still unclear whether high-frequency surveillance using AP-CT in patients with these risk factors is superior to that in the low-frequency surveillance. PATIENTS AND METHODS We retrospectively reviewed 1803 patients with stage II-III colon cancer receiving curative surgery between January 1, 2005 to December 31, 2015. We evaluated the average scan-to-scan intervals of postoperative AP-CT testing and assigned patients with an interval of 5 to 8 and 9 to 13 months to the high-frequency (HF) and low-frequency (LF) groups, respectively. The cutoff value of preoperative and postoperative CEA levels was 5 ng/mL. We also applied propensity score matching (PSM) and inverse probability of treatment weighting to adjust clinicopathologic differences between the 2 groups. RESULTS We matched 1:1 for each surveillance group yielding a cohort of 776 matched patients. After PSM, Baseline demographics were overall well balanced between 2 groups. Stage III (OR, 2.00; 95% Confidence interval [CI], 1.21-3.30) and postoperative CEA elevation (OR, 2.30; 95% CI, 1.08-4.92) were independent risk factors of recurrence in multivariate analyses. Patient in the HF group had more surgery plus chemo- or radiotherapy as postrecurrence treatment than patient in the LF group (46.2% vs. 23.1%, P = .017). This trend was retained after PSM, although it is not significant (44.4% vs. 23.1%, P = .060). However, survival outcomes of high-frequency AP-CT surveillance were not superior to those of low-frequency surveillance in all subgroups, including stage III (HR 0.99, 95% CI 0.40-2.47) and postoperative CEA elevation (HR 1.36, 95% CI 0.45-4.11). CONCLUSION High-frequency AP-CT testing is associated with a higher proportion of surgery plus chemo- or radiotherapy as postrecurrence treatment, without improvement in 5-year overall survival.
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Affiliation(s)
| | - Da Bin Lee
- Yonsei University College of Medicine, Seoul, Korea
| | - Sang Joon Shin
- Yonsei Cancer Center, Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Dai Hoon Han
- Department of Hepatobiliary and Pancreatic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jee Suk Chang
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yoon Dae Han
- Department of Colorectal Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyunwook Kim
- Yonsei Cancer Center, Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Joon Seok Lim
- Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - Han Sang Kim
- Yonsei Cancer Center, Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea; Graduate School of Medical Science, Brain Korea 21 FOUR Project, Yonsei University College of Medicine, Seoul, Korea.
| | - Joong Bae Ahn
- Yonsei Cancer Center, Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
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Gwenzi T, Zhu A, Schrotz-King P, Schöttker B, Hoffmeister M, Edelmann D, Brenner H. Prognostic Value of Post-Operative C-Reactive Protein-Based Inflammatory Biomarkers in Colorectal Cancer Patients: Systematic Review and Meta-Analysis. Clin Epidemiol 2023; 15:795-809. [PMID: 37396024 PMCID: PMC10314753 DOI: 10.2147/clep.s415171] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 06/09/2023] [Indexed: 07/04/2023] Open
Abstract
Post-operative inflammation in cancer patients can be modulated by drugs and diets, but evidence on its prognostic role, which would be crucial for personalized treatment and surveillance schemes, remains rather limited. We aimed to systematically review and meta-analyse studies on the prognostic value of post-operative C-reactive protein (CRP)-based inflammatory biomarkers among patients with colorectal cancer (CRC) (PROSPERO#: CRD42022293832). PubMed, Web of Science and Cochrane databases were searched until February 2023. Studies reporting associations between post-operative CRP, Glasgow Prognostic Score (GPS) or modified Glasgow Prognostic Score (mGPS) with overall survival (OS), CRC-specific survival (CSS) and recurrence-free survival (RFS) were included. Hazard ratios (HRs) with 95% confidence intervals (CIs) for the predictor-outcome associations were pooled using R-software, version 4.2. Sixteen studies (n = 6079) were included in the meta-analyses. Elevated post-operative CRP was a predictor of poor OS, CSS and RFS compared with low CRP levels [HR (95% CI): 1.72 (1.32-2.25); 1.63 (1.30-2.05); 2.23 (1.44-3.47), respectively]. A unit increase in post-operative GPS predicted poor OS [HR (95% Cl): 1.31 (1.14-1.51)]. Moreover, a unit increase in post-operative mGPS was associated with poor OS and CSS [HR (95% Cl): 1.93 (1.37-2.72); 3.16 (1.48-6.76), respectively]. Post-operative CRP-based inflammatory biomarkers have a significant prognostic role for patients with CRC. Prognostic value of these easy-to-obtain routine measurements thereby seems to outperform most of the much more complex blood- or tissue-based predictors in the current focus of multi-omics-based research. Future studies should validate our findings, establish optimal time for biomarker assessment and determine clinically useful cut-off values of these biomarkers for post-operative risk-stratification and treatment-response monitoring.
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Affiliation(s)
- Tafirenyika Gwenzi
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, 69120, Germany
- Medical Faculty Heidelberg, Heidelberg University, Heidelberg, 69120, Germany
| | - Anna Zhu
- Medical Faculty Heidelberg, Heidelberg University, Heidelberg, 69120, Germany
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, 69120, Germany
| | - Petra Schrotz-King
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, 69120, Germany
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, 69120, Germany
| | - Michael Hoffmeister
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, 69120, Germany
| | - Dominic Edelmann
- Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, 69120, Germany
| | - Hermann Brenner
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, 69120, Germany
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, 69120, Germany
- Network Aging Research, Heidelberg University, Heidelberg, 69115, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, 69120, Germany
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Prognostic value of lymphovascular and perineural invasion in colorectal cancer. JOURNAL OF SURGERY AND MEDICINE 2023. [DOI: 10.28982/josam.7561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
Background/Aim: Lymphovascular and perineural invasion (LVI and PNI, respectively) are associated with poor prognosis in various cancers. We sought to identify clinical variables associated with LVI and PNI in colorectal cancer (CRC) and their effects on survival.
Methods: Our study design is consistent with a retrospective cohort study. Data from 237 patients with documented LVI or PNI who underwent surgery for colorectal cancer between 2017 and 2021 were retrospectively reviewed. Demographic characteristics, surgery and pathology reports, disease-free and overall survival (DFS and OS, respectively) of the patients were examined.
Results: When the DFS duration of the patients were evaluated, The mean DFS of the LVI-negative group was 27.4 (15.09) months, and the mean of the LVI-positive patients was 20.45 (13) months. DFS was longer in the LVI-negative group (P<0.001). DFS was 52.26 (1.89) months in PNI-negative patients and 34.29 (2.71) months in PNI-positive patients. DFS expectation of PNI-positive patients was approximately 18 months less than that of negative patients (P<0.001). When the patients were evaluated in terms of OS duration, no significant difference was observed in LVI-negative and -positive patient groups, while the estimated OS duration was 52.29 (1.84) months in PNI-negative patients, and 40.10 (2.49) months in PNI-positive patients. OS was 12 months shorter in PNI-negative patients (P<0.001).
Conclusion: The use of PNI and LVI together was found to have a significant impact on the survival rates of patients with colorectal cancer. Documenting LVI and PNI status in biopsy specimens can aid in the management, prognosis, and decision-making for treating colorectal tumors.
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Lv Y, Feng Q, Zhang Z, Zheng P, Zhu D, Lin Q, Chen S, Mao Y, Xu Y, Ji M, Xu J, He G. Low ferroptosis score predicts chemotherapy responsiveness and immune-activation in colorectal cancer. Cancer Med 2022; 12:2033-2045. [PMID: 35855531 PMCID: PMC9883409 DOI: 10.1002/cam4.4956] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 01/19/2022] [Accepted: 02/06/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Existing studies for ferroptosis and prognosis in colorectal cancer (CRC) were limited. In this study, we aim to investigate the prognostic role of ferroptosis markers in patients with CRC and exploration of its micro-environmental distributions. METHODS Immunohistochemical staining was performed for CRC patients' tissue microarray. Selection and prognostic validation of markers were based on mRNA data from the cancer genome atlas (TCGA) database. Gene Set Enrichment Analysis (GSEA) was performed to indicate relative immune landmarks and hallmarks. Ferroptosis and immune contexture were examined by CIBERSORT. Survival outcomes were analyzed by Kaplan-Meier analysis and cox analysis. RESULTS A panel of 42 genes was selected. Through mRNA expression difference and prognosis analysis, GPX4, NOX1 and ACSL4 were selected as candidate markers. By IHC, increased GPX4, decreased NOX1 and decreased FACL4 indicate poor prognosis and worse clinical characteristics. Ferroptosis score based on GPX4, NOX1 and ACSL4 was constructed and validated with high C-index. Low ferroptosis score can also demonstrate the better progression free survival and better adjuvant chemotherapy (ACT) responsiveness. Moreover, tumor with low ferroptosis score tend to be infiltrated with more CD4+ T cells, CD8+ T cells and less M1 macrophage. Finally, we found that IFN-γ was potentially the central molecule at the crossroad between ferroptosis and onco-immune response. CONCLUSION Ferroptosis plays important role on CRC tumor progression, ACT response and prognosis. Ferroptosis contributes to immune-supportive responses and IFN-γ was the central molecule for this process.
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Affiliation(s)
- Yang Lv
- Department of General SurgeryZhongshan Hospital, Fudan UniversityShanghaiChina,Colorectal Cancer CenterZhongshan Hospital, Fudan UniversityShanghaiChina
| | - Qing‐Yang Feng
- Department of General SurgeryZhongshan Hospital, Fudan UniversityShanghaiChina,Colorectal Cancer CenterZhongshan Hospital, Fudan UniversityShanghaiChina,Shanghai Engineering Research Center of Colorectal Cancer Minimally Invasive SurgeryShanghaiChina
| | - Zhi‐Yuan Zhang
- Department of General SurgeryZhongshan Hospital, Fudan UniversityShanghaiChina,Colorectal Cancer CenterZhongshan Hospital, Fudan UniversityShanghaiChina
| | - Peng Zheng
- Department of General SurgeryZhongshan Hospital, Fudan UniversityShanghaiChina,Colorectal Cancer CenterZhongshan Hospital, Fudan UniversityShanghaiChina,Shanghai Engineering Research Center of Colorectal Cancer Minimally Invasive SurgeryShanghaiChina
| | - De‐xiang Zhu
- Department of General SurgeryZhongshan Hospital, Fudan UniversityShanghaiChina,Colorectal Cancer CenterZhongshan Hospital, Fudan UniversityShanghaiChina,Shanghai Engineering Research Center of Colorectal Cancer Minimally Invasive SurgeryShanghaiChina
| | - Qi Lin
- Department of General SurgeryZhongshan Hospital, Fudan UniversityShanghaiChina,Colorectal Cancer CenterZhongshan Hospital, Fudan UniversityShanghaiChina,Shanghai Engineering Research Center of Colorectal Cancer Minimally Invasive SurgeryShanghaiChina
| | - Si‐min Chen
- Department of PathologyAffiliated Hospital of Nanjing University of Chinese MedicineNanjingJiangsuChina
| | - Yi‐Hao Mao
- Department of General SurgeryZhongshan Hospital, Fudan UniversityShanghaiChina,Colorectal Cancer CenterZhongshan Hospital, Fudan UniversityShanghaiChina
| | - Yu‐Qiu Xu
- Department of General SurgeryZhongshan Hospital, Fudan UniversityShanghaiChina,Colorectal Cancer CenterZhongshan Hospital, Fudan UniversityShanghaiChina
| | - Mei‐ling Ji
- Department of General SurgeryZhongshan Hospital, Fudan UniversityShanghaiChina,Colorectal Cancer CenterZhongshan Hospital, Fudan UniversityShanghaiChina,Shanghai Engineering Research Center of Colorectal Cancer Minimally Invasive SurgeryShanghaiChina
| | - Jian‐Min Xu
- Department of General SurgeryZhongshan Hospital, Fudan UniversityShanghaiChina,Colorectal Cancer CenterZhongshan Hospital, Fudan UniversityShanghaiChina,Shanghai Engineering Research Center of Colorectal Cancer Minimally Invasive SurgeryShanghaiChina
| | - Guo‐dong He
- Department of General SurgeryZhongshan Hospital, Fudan UniversityShanghaiChina,Colorectal Cancer CenterZhongshan Hospital, Fudan UniversityShanghaiChina,Shanghai Engineering Research Center of Colorectal Cancer Minimally Invasive SurgeryShanghaiChina
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8
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Lee H, Yoo SY, Park IJ, Hong SM, Lim SB, Yu CS, Kim JC. The Prognostic Reliability of Lymphovascular Invasion for Patients with T3N0 Colorectal Cancer in Adjuvant Chemotherapy Decision Making. Cancers (Basel) 2022; 14:cancers14122833. [PMID: 35740498 PMCID: PMC9221415 DOI: 10.3390/cancers14122833] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/28/2022] [Accepted: 06/05/2022] [Indexed: 12/10/2022] Open
Abstract
Simple Summary This retrospective analysis evaluated the prognostic implications of lymphovascular invasion (LVI) associated with adjuvant chemotherapy in 1634 patients with pT3N0 colorectal cancer. Extensive pathologic review and dual immunohistochemical (IHC) staining with CD31 and D2-40 were undertaken in a subset of 242 patients to determine the reliability of LVI as a prognostic factor. The diagnosis of LVI and PNI changed in 82 (33.9%) and 61 (25.2%) patients, respectively, after central pathologic review (mean follow up duration, 50 (1–114) months). Five-year recurrence-free survival (RFS) and overall survival (OS) rates were 92% and 94.8%, respectively. Before and after pathologic review, LVI was not associated with OS but was associated with RFS after reviewing patients with pT3N0 colorectal cancer. In this patient cohort, the prognostic implications of LVI may have been underrecognized when using hematoxylin and eosin staining slides only for pathologic diagnoses, possibly leading to low recurrence prediction rates. Abstract Lymphovascular invasion (LVI) is a high-risk feature guiding decision making for adjuvant chemotherapy. We evaluated the prognostic importance and reliability of LVI as an adjuvant chemotherapy indicator in 1634 patients with pT3N0 colorectal cancer treated with curative radical resection between 2012 and 2016. LVI and perineural invasion (PNI) were identified in 382 (23.5%) and 269 (16.5%) patients, respectively. In total, 772 patients received adjuvant chemotherapy. The five-year recurrence-free survival (RFS) and OS rates were 92% and 94.8%, respectively. Preoperative obstruction, PNI, and positive margins were significantly associated with RFS and OS; however, adjuvant chemotherapy and LVI were not. Pathologic slide central reviews of 242 patients using dual D2-40 and CD31 immunohistochemical staining was performed. In the review cohort, the diagnosis of LVI and PNI was changed in 82 (33.9%) and 61 (25.2%) patients, respectively. Reviewed LVI, encompassing small vessel invasion, lymphatic invasion, and large vessel invasion, was not an independent risk factor associated with OS but was related to RFS. The prognostic importance of LVI and adjuvant chemotherapy was not defined because LVI may be underrecognized in pathologic diagnoses using hematoxylin and eosin staining slides only, leading to low recurrence rate predictions. Using LVI as a guiding factor for adjuvant chemotherapy requires further consideration.
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Affiliation(s)
- Hayoung Lee
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea;
| | - Seung-Yeon Yoo
- Pathology Center, Seegene Medical Foundation, Seoul 133847, Korea;
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - In Ja Park
- Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (S.-B.L.); (C.S.Y.); (J.C.K.)
- Correspondence: (I.J.P.); (S.-M.H.); Tel.: +82-2-3010-3937 (I.J.P.); +82-2-3010-4889 (S.-M.H.)
| | - Seung-Mo Hong
- Pathology Center, Seegene Medical Foundation, Seoul 133847, Korea;
- Correspondence: (I.J.P.); (S.-M.H.); Tel.: +82-2-3010-3937 (I.J.P.); +82-2-3010-4889 (S.-M.H.)
| | - Seok-Byung Lim
- Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (S.-B.L.); (C.S.Y.); (J.C.K.)
| | - Chang Sik Yu
- Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (S.-B.L.); (C.S.Y.); (J.C.K.)
| | - Jin Cheon Kim
- Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (S.-B.L.); (C.S.Y.); (J.C.K.)
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9
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Ma L, Li W, Liu N, Ding Z, Cai J, Zhang Y. Prothrombin time (PT) and CEA as prognostic predictive biomarkers for postoperative recurrence after curative resection in patients with stage I-III colorectal cancer: a retrospective cohort study. Updates Surg 2022; 74:999-1009. [PMID: 35322387 DOI: 10.1007/s13304-022-01268-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 03/04/2022] [Indexed: 11/29/2022]
Abstract
There are no ideal biomarkers including the TNM stage that can accurately predict the recurrence of colorectal cancer (CRC) and the benefit of chemotherapy for stage II patients. Here, 451 CRC patients were divided into three groups according to preoperative levels of prothrombin time (PT) and CEA to analyze the value of these indexes in predicting postoperative recurrence in different TNM stages. Preoperatively elevated levels of PT and CEA were significantly associated with a high 5-year cumulative recurrence rate (CRR) and short recurrence-free survival (RFS). According to PT and CEA levels, the 5-year CRR and RFS differed significantly among the High-risk (PT ≥ 12.65 s and CEA ≥ 10.175 ng/ml), Middle-risk (PT ≥ 12.65 s or CEA ≥ 10.175 ng/ml), and Low-risk (PT < 12.65 s and CEA < 10.175 ng/ml) groups (p < 0.001). In the same TNM stage, the 5-year CRR of the High-risk group was significantly higher and the RFS was markedly shorter than those in the Low-risk and even those in stage III (p < 0.001). In the subgroup of early stage (stage I and II), the 5-year CRR of the High-risk group was significantly higher and the RFS was significantly shorter than those in stage IIIA and IIIB (p < 0.001), which is similar to IIIC. In conclusion, preoperatively elevated levels of serum PT and CEA were reliable predictors of postoperative high-risk recurrence in CRC and combined with TNM stage precisely identify postoperative recurrence CRC patients in stage I-III and the benefit of adjuvant chemotherapy for patients with stage II CRC.
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Affiliation(s)
- Lulu Ma
- Department of Gastrointestinal Surgery, Zhongshan Hospital of Xiamen University, Xiamen, 361000, China.,Gastrointestinal Oncology Center of Xiamen University, Xiamen, 361000, China.,Medical College of Xiamen University, Xiamen, 361000, China
| | - Wenya Li
- Department of Gastrointestinal Surgery, Zhongshan Hospital of Xiamen University, Xiamen, 361000, China.,Gastrointestinal Oncology Center of Xiamen University, Xiamen, 361000, China.,Medical College of Xiamen University, Xiamen, 361000, China
| | - Ningquan Liu
- Department of Gastrointestinal Surgery, Zhongshan Hospital of Xiamen University, Xiamen, 361000, China.,Gastrointestinal Oncology Center of Xiamen University, Xiamen, 361000, China.,Medical College of Xiamen University, Xiamen, 361000, China
| | - Zhijie Ding
- Department of Gastrointestinal Surgery, Zhongshan Hospital of Xiamen University, Xiamen, 361000, China.,Gastrointestinal Oncology Center of Xiamen University, Xiamen, 361000, China.,Medical College of Xiamen University, Xiamen, 361000, China
| | - Jianchun Cai
- Department of Gastrointestinal Surgery, Zhongshan Hospital of Xiamen University, Xiamen, 361000, China.,Gastrointestinal Oncology Center of Xiamen University, Xiamen, 361000, China.,Medical College of Xiamen University, Xiamen, 361000, China
| | - Yiyao Zhang
- Department of Gastrointestinal Surgery, Zhongshan Hospital of Xiamen University, Xiamen, 361000, China. .,Gastrointestinal Oncology Center of Xiamen University, Xiamen, 361000, China. .,Medical College of Xiamen University, Xiamen, 361000, China.
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10
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Osterman E, Ekström J, Sjöblom T, Kørner H, Myklebust TÅ, Guren MG, Glimelius B. Accurate population-based model for individual prediction of colon cancer recurrence. Acta Oncol 2021; 60:1241-1249. [PMID: 34279175 DOI: 10.1080/0284186x.2021.1953138] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Prediction models are useful tools in the clinical management of colon cancer patients, particularly when estimating the recurrence rate and, thus, the need for adjuvant treatment. However, the most used models (MSKCC, ACCENT) are based on several decades-old patient series from clinical trials, likely overestimating the current risk of recurrence, especially in low-risk groups, as outcomes have improved over time. The aim was to develop and validate an updated model for the prediction of recurrence within 5 years after surgery using routinely collected clinicopathologic variables. MATERIAL AND METHODS A population-based cohort from the Swedish Colorectal Cancer Registry of 16,134 stage I-III colon cancer cases was used. A multivariable model was constructed using Cox proportional hazards regression. Three-quarters of the cases were used for model development and one quarter for internal validation. External validation was performed using 12,769 stage II-III patients from the Norwegian Colorectal Cancer Registry. The model was compared to previous nomograms. RESULTS The nomogram consisted of eight variables: sex, sidedness, pT-substages, number of positive and found lymph nodes, emergency surgery, lymphovascular and perineural invasion. The area under the curve (AUC) was 0.78 in the model, 0.76 in internal validation, and 0.70 in external validation. The model calibrated well, especially in low-risk patients, and performed better than existing nomograms in the Swedish registry data. The new nomogram's AUC was equal to that of the MSKCC but the calibration was better. CONCLUSION The nomogram based on recently operated patients from a population registry predicts recurrence risk more accurately than previous nomograms. It performs best in the low-risk groups where the risk-benefit ratio of adjuvant treatment is debatable and the need for an accurate prediction model is the largest.
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Affiliation(s)
- E. Osterman
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
- Department of Surgery, Region Gävleborg, Gävle, Sweden
| | - J. Ekström
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - T. Sjöblom
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - H. Kørner
- Institute of Clinical Science, University of Bergen, Bergen, Norway
- Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway
| | - T. Å. Myklebust
- Department of Registration, Cancer Registry of Norway, Oslo, Norway
- Department of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway
| | - M. G. Guren
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - B. Glimelius
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
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11
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Osterman E, Hammarström K, Imam I, Osterlund E, Sjöblom T, Glimelius B. Completeness and accuracy of the registration of recurrences in the Swedish Colorectal Cancer Registry (SCRCR) and an update of recurrence risk in colon cancer. Acta Oncol 2021; 60:842-849. [PMID: 33689551 DOI: 10.1080/0284186x.2021.1896033] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND The completeness and accuracy of the registration of synchronous metastases and recurrences in the Swedish Colorectal Cancer Registry has not been investigated. Knowing how accurate these parameters are in the registry is a prerequisite to adequately measure the current recurrence risk. METHODS All charts for patients diagnosed with stage I-III colorectal cancer (CRC) in two regions were reviewed. In one of the regions, all registrations of synchronous metastases were similarly investigated. After the database had been corrected, recurrence risk in colon cancer was calculated stratified by risk group as suggested by ESMO in 2020. RESULTS In patients operated upon more than five years ago (N = 1235), there were 20 (1.6%) recurrences not reported. In more recent patients, more recurrences were unreported (4.0%). Few synchronous metastases were wrongly registered (3.6%) and, likewise, few synchronous metastases were not registered (about 1%). The five-year recurrence risk in stage II was 6% for low-risk, 11% for intermediate risk, and 23% for high-risk colon cancer patients. In stage III, it was 25% in low- and 45% in high-risk patients. Incorporation of risk factors in stage III modified the risks substantially even if this is not considered by ESMO. Adjuvant chemotherapy lowered the risk in stage III but not to any relevant extent in stage II. CONCLUSION The registration of recurrences in the registry after 5 years is accurate to between 1 and 2% but less accurate earlier. A small number of unreported recurrences and falsely reported recurrences were discovered in the chart review. The recurrence risk in this validated and updated patient series matches what has been recently reported, except for the risk of recurrence in stage II low risk colon cancers which seem to be even a few percentage points lower (6 vs. 9%).
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Affiliation(s)
- Erik Osterman
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
- Department of Surgery, Region Gävleborg, Gävle Hospital, Gävle, Sweden
| | - Klara Hammarström
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Israa Imam
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Emerik Osterlund
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Tobias Sjöblom
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Bengt Glimelius
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
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12
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Recurrence Risk after Radical Colorectal Cancer Surgery-Less Than before, But How High Is It? Cancers (Basel) 2020; 12:cancers12113308. [PMID: 33182510 PMCID: PMC7696064 DOI: 10.3390/cancers12113308] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/27/2020] [Accepted: 11/06/2020] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Evidence indicates that recurrence risk after colon cancer today is less than it was when trials performed decades ago showed that adjuvant chemotherapy reduces the risk and prolong disease-free and overall survival. After rectal cancer surgery, local recurrence rates have decreased but it is unclear if systemic recurrences have. After a systematic review of available literature reporting recurrence risks after curative colorectal cancer surgery we report that the risks are lower today than they were in the past and that this risk reduction is not solely ascribed to the use of adjuvant therapy. Adjuvant therapy always means overtreatment of many patients, already cured by the surgery. Fewer recurrences mean that progress in the care of these patients has happened but also that the present guidelines giving recommendations based upon old data must be adjusted. The relative gains from adding chemotherapy are not altered, but the absolute number of patients gaining is less. Abstract Adjuvant chemotherapy aims at eradicating tumour cells sometimes present after radical surgery for a colorectal cancer (CRC) and thereby diminish the recurrence rate and prolong time to recurrence (TTR). Remaining tumour cells will lead to recurrent disease that is usually fatal. Adjuvant therapy is administered based upon the estimated recurrence risk, which in turn defines the need for this treatment. This systematic overview aims at describing whether the need has decreased since trials showing that adjuvant chemotherapy provides benefits in colon cancer were performed decades ago. Thanks to other improvements than the administration of adjuvant chemotherapy, such as better staging, improved surgery, the use of radiotherapy and more careful pathology, recurrence risks have decreased. Methodological difficulties including intertrial comparisons decades apart and the present selective use of adjuvant therapy prevent an accurate estimate of the magnitude of the decreased need. Furthermore, most trials do not report recurrence rates or TTR, only disease-free and overall survival (DFS/OS). Fewer colon cancer patients, particularly in stage II but also in stage III, today display a sufficient need for adjuvant treatment considering the burden of treatment, especially when oxaliplatin is added. In rectal cancer, neo-adjuvant treatment will be increasingly used, diminishing the need for adjuvant treatment.
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13
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Glimelius B. TOSCA-a delicious Swedish almond cake, an Italian opera and an Italian trial with important new data. Ann Oncol 2020; 32:6-8. [PMID: 33341192 DOI: 10.1016/j.annonc.2020.10.598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 10/28/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
- B Glimelius
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.
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14
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Lee MW, Kim JS, Kim JY, Lee KH. Prognostic Factor and Survival Benefit of Adjuvant Chemotherapy in Stage IIA Colon Cancer. Ann Coloproctol 2020; 37:35-43. [PMID: 32972104 PMCID: PMC7989565 DOI: 10.3393/ac.2020.09.03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 09/03/2020] [Indexed: 01/04/2023] Open
Abstract
Purpose There is no clear evidence of the benefit of adjuvant chemotherapy (AC) in stage IIA colon cancer. Therefore, we aimed to evaluate the prognostic factors and survival benefit of AC in this disease. Methods A retrospective data collection for patients who underwent radical surgery for colon cancer between January 2008 and December 2015 was undertaken. The cohort was divided into the no-AC and AC groups. Results We included 227 patients with stage IIA colon cancer in our study cohort, including 67 and 160 patients in the no-AC and AC groups, respectively. The number of retrieved lymph nodes and the presence of tumor complications as obstruction or perforation were independent risk factors for survival. In the no-AC group, there was a significant difference in survival according to the number of retrieved lymph nodes. In the AC group, there were significant differences in survival according to sidedness and preoperative carcinoembryonic antigen (CEA). There was no significant difference in survival between the no-AC and the AC groups. Conclusion The number of retrieved lymph nodes and the presence of tumor complications were prognostic factors for stage IIA colon cancer but lymphovascular and perineural invasion were not. Sidedness and preoperative CEA could be used as factors to predict the benefit of adjuvant chemotherapy. Currently, it is believed that there is no benefit of AC for stage IIA colon cancer. Further studies are needed to determine the survival benefit of adjuvant chemotherapy in stage IIA colon cancer.
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Affiliation(s)
- Mok-Won Lee
- Department of Surgery, Chungnam National University Hospital, Daejeon, Korea
| | - Jin-Su Kim
- Department of Surgery, Chungnam National University Hospital, Daejeon, Korea
| | - Ji-Yeon Kim
- Department of Surgery, Chungnam National University Hospital, Daejeon, Korea
| | - Kyung-Ha Lee
- Department of Surgery, Chungnam National University Hospital, Daejeon, Korea
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15
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Glimelius B, Osterman E. Adjuvant Chemotherapy in Elderly Colorectal Cancer Patients. Cancers (Basel) 2020; 12:cancers12082289. [PMID: 32823998 PMCID: PMC7464071 DOI: 10.3390/cancers12082289] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/10/2020] [Accepted: 08/12/2020] [Indexed: 12/13/2022] Open
Abstract
The value of adjuvant chemotherapy in elderly patients has been the subject of many overviews, with opinions varying from “not effective”, since randomized trials have not been performed, to “as effective as in young individuals”, based upon many retrospective analyses of randomized trials that have included patients of all ages. In the absence of randomized trials performed specifically with elderly patients, retrospective analyses demonstrate that the influence on the time to tumour recurrence (TTR) may be the same as in young individuals, but that endpoints that include death for any reason, such as recurrence-free survival (RFS), disease-free survival (DFS), and overall survival (OS), are poorer in the elderly. This is particularly true if oxaliplatin has been part of the treatment. The need for adjuvant chemotherapy after colorectal cancer surgery in elderly patients is basically the same as that in younger patients. The reduction in recurrence risks may be similar, provided the chosen treatment is tolerated but survival gains are less. Adding oxaliplatin to a fluoropyrimidine is probably not beneficial in individuals above a biological age of approximately 70 years. If an oxaliplatin combination is administered to elderly patients, three months of therapy is in all probability the most realistic goal.
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Affiliation(s)
- Bengt Glimelius
- Department of Immunology, Genetics and Pathology, Uppsala University, SE-75185 Uppsala, Sweden;
- Correspondence: ; Tel.: +46-18-611-24-32
| | - Erik Osterman
- Department of Immunology, Genetics and Pathology, Uppsala University, SE-75185 Uppsala, Sweden;
- Department of Surgery, Gävle Hospital, Region Gävleborg, SE-80187 Gävle, Sweden
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16
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Zhou P, Xie W, Huang HL, Huang RQ, Tian C, Zhu HB, Dai YH, Li ZY. circRNA_100859 functions as an oncogene in colon cancer by sponging the miR-217-HIF-1α pathway. Aging (Albany NY) 2020; 12:13338-13353. [PMID: 32644049 PMCID: PMC7377858 DOI: 10.18632/aging.103438] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 05/30/2020] [Indexed: 02/06/2023]
Abstract
Circular RNAs (circRNAs) play an important role in cancer development and progression by regulating gene expression. The present study aimed to investigate the function of circRNA_100859 in colon cancer. circRNA expression profiles from a human circRNAs chip were analyzed. The effects of circRNA_100859 on cell proliferation and apoptosis were assessed in vitro and interactions between circRNA_100859 and its micro (mi)RNA and target genes were analyzed. The diagnostic and prognostic significance of circRNA_100859 was also investigated. It was identified that circRNA_100859 was overexpressed in colon cancer tissues and promoted cell proliferation and inhibited cell apoptosis. Additionally, bioinformatics and a dual-luciferase reporter assay confirmed that circRNA_100859 acted as a miR-217 sponge, and miR-217 directly targeted hypoxia-inducible factor (HIF)-1α. Rescue assays demonstrated that HIF-1α protein and mRNA expression levels and cell proliferation were regulated by the circRNA_100859/miR-217 axis (P<0.05). Furthermore, statistical analysis showed that the circRNA_100859-miR-217-HIF-1α axis was associated with Tumor-Node-Metastasis (TNM) stage, histological grade, and KRAS mutations, and also showed high diagnostic and prognostic value for patients with colon cancer (P<0.05). Therefore, it was concluded that circRNA_100859 functions as an oncogene in colon cancer by sponging the miR-217-HIF-1α pathway. In addition, the circRNA_100859-miR-217-HIF-1α axis may serve as a novel diagnostic and prognostic biomarker for patients with colon cancer.
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Affiliation(s)
- Peng Zhou
- Department of Anatomy and Neurobiology, School of Basic Medical Sciences, Central South University, Changsha, Hunan, China.,Department of Pathology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Wei Xie
- Department of Anatomy and Neurobiology, School of Basic Medical Sciences, Central South University, Changsha, Hunan, China
| | - Hua-Lin Huang
- CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China.,Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China
| | - Rong-Qi Huang
- CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China.,Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China
| | - Chao Tian
- CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China.,Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China.,School of Life Sciences, University of Science and Technology of China, Hefei, China
| | - Hong-Bo Zhu
- Hepatology Unit and Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Ying-Huan Dai
- Department of Pathology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhi-Yuan Li
- Department of Anatomy and Neurobiology, School of Basic Medical Sciences, Central South University, Changsha, Hunan, China.,CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China.,Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China.,School of Life Sciences, University of Science and Technology of China, Hefei, China.,GZMU-GIBH Joint School of Life Sciences, Guangzhou Medical University, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
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17
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Osterman E, Glimelius B. ASO Author Reflections: Emerging Risk Factors in Colon Cancer-End of the Line for Clinomics? Ann Surg Oncol 2019; 27:1046-1047. [PMID: 31884560 PMCID: PMC7060154 DOI: 10.1245/s10434-019-08149-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Erik Osterman
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden. .,Department of Surgery, Gävle Hospital, Gävle, Sweden.
| | - Bengt Glimelius
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.,Department of Oncology, Uppsala University Hospital, Uppsala, Sweden
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18
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Kwaan MR. Postoperative CEA and Other Non-traditional Risk Factors for Colon Cancer Recurrence: Findings from Swedish Population-Based Data. Ann Surg Oncol 2019; 27:971-972. [PMID: 31853758 DOI: 10.1245/s10434-019-08151-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Mary R Kwaan
- Division of General Surgery, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
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