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01.12.2012 | Research | Ausgabe 1/2012 Open Access

World Journal of Surgical Oncology 1/2012

A novel sialyl LeX expression score as a potential prognostic tool in colorectal cancer

World Journal of Surgical Oncology > Ausgabe 1/2012
Leif Schiffmann, Fabian Schwarz, Michael Linnebacher, Friedrich Prall, Jens Pahnke, Helga Krentz, Brigitte Vollmar, Ernst Klar
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1477-7819-10-95) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

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.
Authors’ original file for figure 1
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