qRT-PCR analysis of CEACAM5, KLK6, SLC35D3, MUC2 and POSTN in colon cancer lymph nodes: An improved method for assessment of tumor stage and prognosisHiloProbe AB, Umeå, Sweden.
HiloProbe AB, Umeå, Sweden.
Umeå University, Faculty of Medicine, Department of Clinical Microbiology. Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology. Department of Molecular Biology, Genetic Engineering, and Biotechnology Research Institute, University of Sadat City, Sadat City, Menoufia, Egypt.
Department of Surgery, Blekinge Hospital, Karlskrona, Sweden.
Department of Clinical Pathology and Cytology, Blekinge Hospital, Karlskrona, Sweden.
Department of Clinical Pathology and Cytology, Blekinge Hospital, Karlskrona, Sweden.
Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden; Department of Surgery, Gävle Hospital, Gävle, Sweden.
Department of Clinical Pathology and Cytology, Gävle Hospital, Gävle, Sweden.
Colorectal Unit, Department of Surgery and Urology, Mälarsjukhuset, Eskilstuna, Sweden.
Unilabs, Clinical Pathology and Cytology, Mälarsjukhuset, Eskilstuna, Sweden.
Unit for Surgery, Örnsköldsvik Hospital, Örnsköldsvik, Sweden.
Centrum for Surgery, Sundsvall Hospital, Sundsvall, Sweden.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery. Department of Surgery, Skellefteå Hospital, Skellefteå, Sweden.
Department of Clinical Pathology, Linköping University Hospital, Linköping, Sweden.
Department of Surgery in Norrköping, Linköping University, Norrköping, Sweden; Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
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2024 (English)In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 154, no 3, p. 573-584Article in journal (Refereed) Published
Abstract [en]
One fourth of colorectal cancer patients having curative surgery will relapse of which the majority will die. Lymph node (LN) metastasis is the single most important prognostic factor and a key factor when deciding on postoperative treatment. Presently, LN metastases are identified by histopathological examination, a subjective method analyzing only a small LN volume and giving no information on tumor aggressiveness. To better identify patients at risk of relapse we constructed a qRT-PCR test, ColoNode, that determines levels of CEACAM5, KLK6, SLC35D3, MUC2 and POSTN mRNAs. Combined these biomarkers estimate the tumor cell load and aggressiveness allocating patients to risk categories with low (0, −1), medium (1), high (2) and very high (3) risk of recurrence. Here we present result of a prospective, national multicenter study including 196 colon cancer patients from 8 hospitals. On average, 21 LNs/patient, totally 4698 LNs, were examined by both histopathology and ColoNode. At 3-year follow-up, 36 patients had died from colon cancer or lived with recurrence. ColoNode identified all patients that were identified by histopathology and in addition 9 patients who were undetected by histopathology. Thus, 25% of the patients who recurred were identified by ColoNode only. Multivariate Cox regression analysis proved ColoNode (1, 2, 3 vs 0, −1) as a highly significant risk factor with HR 4.24 [95% confidence interval, 1.42-12.69, P =.01], while pTN-stage (III vs I/II) lost its univariate significance. In conclusion, ColoNode surpassed histopathology by identifying a significantly larger number of patients with future relapse and will be a valuable tool for decisions on postoperative treatment.
Place, publisher, year, edition, pages
John Wiley & Sons, 2024. Vol. 154, no 3, p. 573-584
Keywords [en]
colon cancer, ColoNode, lymph nodes, prognosis, tumor markers
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:umu:diva-214620DOI: 10.1002/ijc.34718ISI: 001067494700001PubMedID: 37700602Scopus ID: 2-s2.0-85170666995OAI: oai:DiVA.org:umu-214620DiVA, id: diva2:1800523
Funder
Region VästerbottenSwedish Cancer SocietySwedish Research Council, 2017-00675The Kempe FoundationsUmeå UniversityVinnova2023-09-272023-09-272024-01-12Bibliographically approved