Abstract：
BACKGROUND: Epithelial-mesenchymal transition (EMT) is a key step in the development of colorectal cancer (CRC) that confers metastatic capabilities to cancer cells. The present study aimed to assess the immunohistochemical (IHC) expression and impact of EMT markers, including E-cadherin, Vimentin, β-catenin, and SMAD4, on the oncologic outcomes of CRC.
METHODS: This was a retrospective review of 118 CRC patients. Tissue slides were retrieved from the slide archive and five tissue microarray construction blocks were constructed. IHC for E-cadherin, Vimentin, β-catenin, and SMAD4 was done. The main outcome was the association between abnormal marker expression and overall survival (OS), and disease-free survival (DFS).
RESULTS: Adenocarcinomas accounted for 71.2% of tumors, whereas 25.4% and 3.4% were mucinous and signet ring cell carcinomas. The rates of lymphovascular invasion and perineural invasion were 72.9% and 20.3%, respectively. There was a positive, significant correlation, and association between the four markers. Abnormal expression of E-cadherin was associated with significantly lower OS (p < 0.0001) and similar DFS (p = 0.06). Abnormal Vimentin expression was associated with a significantly higher rate of distant metastasis (p = 0.005) and significantly lower OS and DFS (p < 0.0001). Abnormal expression of β-catenin was associated with significantly lower OS (p < 0.0001) and similar DFS (p = 0.15). Abnormal expression of SMAD4 was associated with significantly lower OS and DFS (p < 0.0001). Abnormal expression of all four markers was associated with a higher disease recurrence, lower OS, and lower DFS.
CONCLUSIONS: Abnormal expression of each marker was associated with lower OS, whereas abnormal expression of Vimentin and SMAD4 only was associated with lower DFS.
METHODS: This was a retrospective review of 118 CRC patients. Tissue slides were retrieved from the slide archive and five tissue microarray construction blocks were constructed. IHC for E-cadherin, Vimentin, β-catenin, and SMAD4 was done. The main outcome was the association between abnormal marker expression and overall survival (OS), and disease-free survival (DFS).
RESULTS: Adenocarcinomas accounted for 71.2% of tumors, whereas 25.4% and 3.4% were mucinous and signet ring cell carcinomas. The rates of lymphovascular invasion and perineural invasion were 72.9% and 20.3%, respectively. There was a positive, significant correlation, and association between the four markers. Abnormal expression of E-cadherin was associated with significantly lower OS (p < 0.0001) and similar DFS (p = 0.06). Abnormal Vimentin expression was associated with a significantly higher rate of distant metastasis (p = 0.005) and significantly lower OS and DFS (p < 0.0001). Abnormal expression of β-catenin was associated with significantly lower OS (p < 0.0001) and similar DFS (p = 0.15). Abnormal expression of SMAD4 was associated with significantly lower OS and DFS (p < 0.0001). Abnormal expression of all four markers was associated with a higher disease recurrence, lower OS, and lower DFS.
CONCLUSIONS: Abnormal expression of each marker was associated with lower OS, whereas abnormal expression of Vimentin and SMAD4 only was associated with lower DFS.
摘要：
背景：上皮-间质转化（EMT）是结直肠癌（CRC）发展的关键步骤，它赋予癌细胞转移能力。本研究旨在评估免疫组织化学（IHC）表达和EMT标志物的影响，包括E-cadherin,Vimentin,β-连环蛋白，和SMAD4，关于CRC的肿瘤学结局。
方法：这是118例CRC患者的回顾性分析。从载玻片存档中检索组织载玻片并构建五个组织微阵列构建块。E-cadherin的IHC，Vimentin,β-连环蛋白，SMAD4完成了。主要结果是异常标记表达与总生存期（OS）之间的关联，无病生存率（DFS）。
结果：腺癌占肿瘤的71.2%，而25.4％和3.4％是粘液性和印戒细胞癌。淋巴管浸润和神经周浸润率分别为72.9%和20.3%,分别。有一个积极的，显著的相关性，以及四个标记之间的关联。E-cadherin的异常表达与显著较低的OS(p<0.0001)和相似的DFS(p=0.06)相关。波形蛋白表达异常与远处转移率显著升高(p=0.005)和OS和DFS显著降低(p<0.0001)相关。β-catenin的异常表达与显著较低的OS(p<0.0001)和相似的DFS(p=0.15)相关。SMAD4的异常表达与显著降低的OS和DFS相关(p<0.0001)。所有四种标记物的异常表达与更高的疾病复发相关。较低的操作系统，和较低的DFS。
结论：各标志物的异常表达与较低的OS相关，而仅Vimentin和SMAD4的异常表达与较低的DFS相关。
方法：这是118例CRC患者的回顾性分析。从载玻片存档中检索组织载玻片并构建五个组织微阵列构建块。E-cadherin的IHC，Vimentin,β-连环蛋白，SMAD4完成了。主要结果是异常标记表达与总生存期（OS）之间的关联，无病生存率（DFS）。
结果：腺癌占肿瘤的71.2%，而25.4％和3.4％是粘液性和印戒细胞癌。淋巴管浸润和神经周浸润率分别为72.9%和20.3%,分别。有一个积极的，显著的相关性，以及四个标记之间的关联。E-cadherin的异常表达与显著较低的OS(p<0.0001)和相似的DFS(p=0.06)相关。波形蛋白表达异常与远处转移率显著升高(p=0.005)和OS和DFS显著降低(p<0.0001)相关。β-catenin的异常表达与显著较低的OS(p<0.0001)和相似的DFS(p=0.15)相关。SMAD4的异常表达与显著降低的OS和DFS相关(p<0.0001)。所有四种标记物的异常表达与更高的疾病复发相关。较低的操作系统，和较低的DFS。
结论：各标志物的异常表达与较低的OS相关，而仅Vimentin和SMAD4的异常表达与较低的DFS相关。
