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    標題: High Expression of EphA4 Predicted Lesser Degree of Tumor Regression after Neoadjuvant Chemoradiotherapy in Rectal Cancer
    作者: Lin, Ching-Yih
    Lee, Ying-En
    Tian, Yu-Feng
    Sun, Ding-Ping
    Sheu, Ming-Jen
    Lin, Chen-Yi
    Li, Chien-Feng
    Lee, Sung-Wei
    Lin, Li-Ching
    Chang, I-Wei
    Wang, Chieh-Tien
    He, Hong-Lin
    貢獻者: Chi Mei Med Ctr, Div Gastroenterol & Hepatol, Dept Internal Med
    Southern Taiwan Univ Sci & Technol, Dept Leisure Recreat & Tourism Management
    KaohsiungChang Gung Mem Hosp, Dept Anesthesiol
    Chang Gung Univ, Coll Med
    Chi Mei Med Ctr, Div Gen Surg, Dept Surg
    Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr
    Chia Nan Univ Pharm & Sci, Dept Pharm
    Chi Mei Med Ctr, Dept Pathol
    Natl Hlth Res Inst, Natl Inst Canc Res
    Southern Taiwan Univ Sci & Technol, Dept Biotechnol
    Kaohsiung Med Univ, Inst Clin Med
    Chi Mei Med Ctr, Dept Radiat Oncol
    I Shou Univ, E DA Hosp, Dept Pathol
    Chi Mei Med Ctr, Dept Pathol
    Chung Hwa Univ Med Technol, Dept Med Lab Sci & Biotechnol
    Natl Sun Yat Sen Univ, Inst Biomed Sci
    關鍵字: EphA4
    rectal cancer
    chemoradiotherapy
    CCRT
    日期: 2017
    上傳時間: 2018-11-30 15:52:49 (UTC+8)
    出版者: Ivyspring Int Publ
    摘要: Background: Numerous transmembrane receptor tyrosine kinase pathways have been found to play an important role in tumor progression in some cancers. This study was aimed to evaluate the clinical impact of Eph receptor A4 (EphA4) in patients with rectal cancer treated with neoadjuvant concurrent chemoradiotherapy (CCRT) combined with mesorectal excision, with special emphasis on tumor regression. Methods: Analysis of the publicly available expression profiling dataset of rectal cancer disclosed that EphA4 was the top-ranking, significantly upregulated, transmembrane receptor tyrosine kinase pathway-associated gene in the non-responders to CCRT, compared with the responders. Immunohistochemical study was conducted to assess the EphA4 expression in pre-treatment biopsy specimens from 172 rectal cancer patients without distant metastasis. The relationships between EphA4 expression and various clinicopathological factors or survival were statistically analyzed. Results: EphA4 expression was significantly associated with vascular invasion (P=0.015), post-treatment depth of tumor invasion (P=0.006), pre-treatment and post-treatment lymph node metastasis (P=0.004 and P=0.011, respectively). More importantly, high EphA4 expression was significantly predictive for lesser degree of tumor regression after CCRT (P=0.031). At univariate analysis, high EphA4 expression was a negative prognosticator for disease-specific survival (P=0.0009) and metastasis-free survival (P=0.0001). At multivariate analysis, high expression of EphA4 still served as an independent adverse prognostic factor for disease-specific survival (HR, 2.528; 95% CI, 1.131-5.651; P=0.024) and metastasis-free survival (HR, 3.908; 95% CI, 1.590-9.601; P=0.003). Conclusion: High expression of EphA4 predicted lesser degree of tumor regression after CCRT and served as an independent negative prognostic factor in patients with rectal cancer.
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