Evaluation of clinical significance of claudin 7 and construction of prognostic grading system for stage II colorectal cancer

摘要

BACKGROUND Claudin 7 is often abnormally expressed in cancers and promotes the progression of some malignancies.However,the role of claudin 7 in stage II colorectal cancer(CRC)has not been studied.AIM To assess the expression and prognostic value of claudin 7 in stage II CRC.METHODS We retrospectively studied 231 stage II CRC patients who underwent radical surgery at our hospital from 2013 to 2014.The protein expression level of claudin 7 was assessed and its relationship with clinicopathological features and prognosis was statistically analyzed.The independent prognostic factors were identified by Cox proportional hazards models.A prognostic grading system was constructed to stratify the survival of CRC patients.RESULTS The expression of claudin 7 was significantly reduced in cancer tissues compared with normal tissues(P<0.001),and its low expression was closely related to recurrence of the disease(P=0.017).Multivariate analysis confirmed that claudin 7 low expression(claudin 7-low)(P=0.028)and perineural invasion positivity(PNI+)(P=0.026)were independent predictors of poor disease-free survival(DFS).A prognostic grading system based on the status of claudin 7 and PNI classified the patients into three prognostic grades:grade A(claudin 7-high and PNI-),grade B(claudin 7-low and PNI-,claudin 7-high and PNI+),and grade C(claudin 7-low and PNI+).The DFS was significantly different among the three grades(grade B vs grade A,P=0.032;grade C vs grade A,P<0.001;grade C vs grade B,P=0.040).CONCLUSION Claudin 7 can be used as a new prognostic marker to predict the DFS of patients with stage II CRC.The prognostic grading system with the addition of claudin 7 can further improve prognosis stratification of patients.