The online version of this article (doi:10.1186/1477-7819-10-95) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
LS and FS conceived and coordinated the study, collected patients’ data, participated in the analysis of the specimens and statistical analysis. LS drafted the manuscript. FP identified the paraffin blocks and participated in preparing the manuscript. JP established the automated staining and participated in developing the new score. HK participated in the statistical analysis. BV participated in conceiving and coordinating the study and preparing the manuscript. ML and EK participated in preparing and drafting the manuscript. All authors read and approved the final manuscript.
Treatment decisions in colorectal cancer subsequent to surgery are based mainly on the TNM system. There is a need to establish novel prognostic markers based on the molecular characterization of tumor cells. Evidence exists that sialyl LeX expression is correlated with an unfavorable outcome in colorectal cancer. The aim of this study was to establish a simple sialyl LeX staining score and to determine a potential correlation with the prognosis in a series of advanced colorectal carcinoma patients.
In order to implement routine use of sialyl LeX immunohistology, we established a new, easily reproducible score and defined a cutoff which discriminated groups with better or worse outcome, respectively. We then correlated sialyl LeX expression of 215 UICC stage III and IV patients with disease-free and cancer-related survival.
A five-stage score could be established based on automated immunohistochemical stainings. Using a statistical model, we calculated a cutoff to discriminate between weak and strong staining positivity of sialyl LeX. Patients with strong positive specimens had a worse cancer-related survival (P = 0.004) but no difference was observed for disease-free survival (P = 0.352).
These results demonstrate a strong correlation between high sialyl LeX-expression in colorectal carcinomas and cancer-related survival. Our highly standardized and easy-to-use staining score is suitable for routine use and hence it could be recommended to evaluate sialyl LeX-expression as part of the standard histopathological analysis of colorectal carcinomas and to validate the score prospectively based on a larger population.
Gesellschaft der epidemiologischen Krebsregister in Deutschland e.V. and Robert Koch-Institut, Krebs in Deutschland - Häufigkeiten und Trends. 2006, Gesellschaft der epidemiologischen Krebsregister in Deutschland e.V, Saarbrücken, p108-5
Nakamori S, Kameyama M, Imaoka S, Furukawa H, Ishikawa O, Sasaki Y, Kabuto T, Iwanaga T, Matsushita Y, Irimura T: Increased expression of sialyl Lewis x antigen correlates with poor survival in patients with colorectal carcinoma: clinicopathological and immunohistochemical study. Cancer Res. 1993, 53: 3632-3637. PubMed
Nakagoe T, Fukushima K, Hirota M, Kusano H, Ayabe H, Tomita M, Kamihira S: Immunohistochemical expression of sialyl Lex antigen in relation to survival of patients with colorectal carcinoma. Cancer. 1993, 72: 2323-2330. 10.1002/1097-0142(19931015)72:8<2323::AID-CNCR2820720807>3.0.CO;2-C. CrossRefPubMed
Grabowski P, Mann B, Mansmann U, Lövin N, Foss HD, Berger G, Scherübl H, Riecken EO, Buhr HJ, Hanski C: Expression of sialyl-Le(x) antigen defined by MAb AM-3 is an independent prognostic marker in colorectal carcinoma patients. Int J Cancer. 2000, 88: 281-286. 10.1002/1097-0215(20001015)88:2<281::AID-IJC21>3.0.CO;2-2. CrossRefPubMed
Zimmerman BJ, Paulson JC, Arrhenius TS, Gaeta FCA, Granger DN: Thrombin receptor peptide-mediated leukocyte rolling in rat mesenteric venules: roles of P-selectin and sialyl Lewis X. Am J Physiol. 1994, 267: H1049-H1053. PubMed
AWMF. Accessed 25 March 2009, http://www.awmf-online.de
Klautke G, Feyerherd F, Ludwig K, Prall F, Foitzik T, Fietkau R: Intensified concurrent chemoradiotherapy with 5-fluorouracil and irinotecan as neoadjuvant treatment in patients with locally advanced rectal cancer. Br J Cancer. 2005, 92: 1215-1220. 10.1038/sj.bjc.6602492. PubMedCentralCrossRefPubMed
TNM Classification of Malignant Tumors. 1997, J. Wiley & Sons, New York, 5
Klein JP, Moeschberger ML: Survival analysis: techniques for censored and truncated data. 1997, Springer, New York CrossRef
Therneau TM, Grambsch PM, Flemenig TR: Martingale-based residuals for survival models. Biometrika. 1990, 77: 147-160. 10.1093/biomet/77.1.147. CrossRef
Fleming TR, Harrington DP: Counting Processes and Survival Analysis. 2005, Wiley-Interscience, Indianapolis, 448- CrossRef
Lee WS, Kim MJ, Yun SH, Chun HK, Lee WY, Kim SJ, Choi SH, Heo JS, Joh JW, Kim YI: Risk factor stratification after simultaneous liver and colorectal resection for synchronous colorectal metastasis. Langenbecks Arch Sur. 2008, 393: 13-19. CrossRef
- A novel sialyl LeX expression score as a potential prognostic tool in colorectal cancer
- BioMed Central
Neu im Fachgebiet Chirurgie
Mail Icon II