COMBINED PHENOTYPE OF FOUR MARKERS IMPROVES PROGNOSTIC VALUE OF COLON CANCER PATIENTS

摘要

Background: Combination of multiple biomarkers representing distinct aspects of tumor biology will have a better prognostic value. This study was to identify prognostic subgroups of colon adenocarcinoma by combined analysis of SNCG, Hiwi, PRL-3, ARD1 and clinicopathologic features in 225 colon adenocarcinoma specimens. Methods: Immunohistochemistry for four tumor markers was performed in whole tissue sections from 225 colon adenocarcinoma patients with complete clinicopathologic data and up to 10-year follow-up. The immunohistochemical expression patterns were examined individually and in multimarker combinations. Univariate and multivariate analyses were done to identify independent predictive markers of poor outcome. Results: With the tumor marker positive rate (32.0% (62/225) for SNCG, 76.9% (173/225) for combined SNCG/Hiwi/PRL-3/ARDl) and the detecting accuracy (61.9% (252/407) for SNCG, 82.6% (336/407) for combined SNCG/Hiwi/PRL-3/ARDl) raising, incremental value of combined SNCG/Hiwi/PRL-3/ARDl (P < 0.001, HR, 3.2) to poor outcome was found. Stratified by lymph node, Hiwi alone (P =0.004, HR, 3.2) led to poor outcome in patients without lymph node metastasis (LN-), and SNCG (P < 0.001, HR, 2.5) had independently poor prognostic value for patients with lymph node metastasis (LN+). Conclusions: Multimarker phenotypes improved tumor positive rate, detecting accuracy and prognostic value. Additionally, a subgroup of more aggressive tumors can be identified by evaluating Hiwi level in LN- cancer, and SNCG level in LN+ cancer.