KMID : 1141920180340040187
|
|
Annals of Coloproctology 2018 Volume.34 No. 4 p.187 ~ p.196
|
|
Gland Attenuation, a Novel Morphological Feature of Colorectal Cancer: Evidence for an Epithelial-Mesenchymal Transition
|
|
Baek Tae-Hwa
Kang Dong-Wook Kim Joo-Heon Son Hyun-Jin
|
|
Abstract
|
|
|
Purpose: Along the invasive margin, colorectal cancer may show distinctive morphologic changes characterized by an asymmetrically attenuating tumor gland with loss of polarity. The author coined the term ¡®gland attenuation (GA)¡¯ for these peculiar changes. The aims of this study were to compare the immunoreactivity of the epithelial-mesenchymal transition (EMT) markers E-cadherin and ¥â-catenin and thus determine whether EMTs occurs at tumor budding (TB) or GA sites and to assess the association of TB and/or GA levels with clinicopathological parameters and prognosis.
Methods: Expression patterns of E-cadherin and ¥â-catenin in the tumor centers at GA and TB sites were examined in 101 patients with well or moderately differentiated CRCs, and the prognostic significance of TB and/or GA was statistically evaluated.
Results: GA foci, as well as TB foci, revealed loss of membranous and cytoplasmic E-cadherin expressions and aberrant ¥â-catenin expression with reduced membranous expression and increased localization to the nucleus, suggesting that EMTs occur in GA as well as in TB. The high-TB and the TB-dominant groups were significantly correlated with advanced invasion depth, presence of lymph node metastasis, advanced pathologic staging and presence of lymphovascular invasion. The high-TB and the TB-dominant groups showed poor overall survival (OS) and recurrence-free survival (RFS), and high TB was an independent prognostic factor in the multivariate analyses for OS and RFS.
Conclusion: This study showed evidence that EMTs occurs at GA sites as well as TB foci. TB is a strong and independent prognostic factor, and TB-dominance may be an indicator of adverse clinical outcome.
|
|
KEYWORD
|
|
Colorectal cancer, Gland attenuation, Tumor budding, Epithelial-mesenchymal transition
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|
|