High Expression of EphA4 Predicted Lesser Degree of Tumor Regression after Neoadjuvant Chemoradiotherapy in Rectal Cancer

doi:10.7150/jca.17471

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Title:	High Expression of EphA4 Predicted Lesser Degree of Tumor Regression after Neoadjuvant Chemoradiotherapy in Rectal Cancer
Authors:	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
Contributors:	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
Keywords:	EphA4 rectal cancer chemoradiotherapy CCRT
Date:	2017
Issue Date:	2018-11-30 15:52:49 (UTC+8)
Publisher:	Ivyspring Int Publ
Abstract:	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.
Relation:	Journal of Cancer, v.8, n.6, pp.1089-1096
Appears in Collections:	[Dept. of Pharmacy] Periodical Articles

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