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- Title
Securin identifies a subgroup of patients with poor outcome in rectal cancer treated with long-course (chemo)radiotherapy.
- Authors
Avoranta, S. Tuulia; Korkeila, Eija A.; Minn, Heikki R. I.; Syrjänen, Kari J.; Pyrhönen, Seppo O.; Sundström, Jari T. T.
- Abstract
Background. Securin is an oncogene with functions in cell proliferation, tumour initiation and progression. Its prognostic value in rectal cancer is somewhat unknown. Accordingly, we studied securin expression together with Ki-67 in rectal cancer in relation to preoperative (chemo)radiotherapy (RT) and disease outcome. Material and methods. Biopsies (n = 65 for securin; n = 57 for Ki-67) and operative specimens (n = 207) from 211 patients treated with short-course RT (n = 87), long-course RT (n = 54) or surgery only (n = 70) were studied with immunohistochemistry (IHC) for securin and Ki-67 expression. In the long-course RT group, 45 patients received chemotherapy (5-fluorouracil or capecitabine) concomitantly with RT. The results of IHC were related to clinicopathological variables, disease outcome and tumour regression grade (TRG) after long-course RT. Results. Both markers showed significant reduction after RT (p < 0.001). No differences in expression was seen in the long-course RT group between the patients with or without concomitant chemotherapy (p = 0.23 for securin; p = 0.31 for Ki-67). Low Ki-67 expression, but not that of securin, in operative specimens was significantly related to excellent TRG (p = 0.02 for Ki-67; p = 0.21 for securin). In univariate survival analysis, excellent TRG predicted longer disease-specific survival (DSS; p = 0.03). In multivariate Cox analysis, high securin expression after long-course (chemo)RT was an independent predictor of shorter DSS (p = 0.036) together with patient age (p = 0.043) and disease recurrence (local or distant; p = 0.009), whereas no similar appearance was seen in other treatment groups. Conclusion. Securin expression in rectal cancer is significantly reduced after RT. High securin expression and poor TRG after long-course (chemo)RT are indicators of unfavourable disease outcome.
- Subjects
ANALYSIS of variance; BIOPSY; CANCER chemotherapy; CELL physiology; CHI-squared test; CONFIDENCE intervals; STATISTICAL correlation; FISHER exact test; IMMUNOHISTOCHEMISTRY; RESEARCH methodology; ONCOGENES; HEALTH outcome assessment; PREOPERATIVE care; RADIATION doses; RECTUM tumors; REGRESSION analysis; RESEARCH funding; STAINS &; staining (Microscopy); STATISTICS; SURVIVAL analysis (Biometry); TISSUE culture; TUMOR markers; TUMOR classification; U-statistics; DATA analysis; TREATMENT effectiveness; INTER-observer reliability; PROPORTIONAL hazards models; DATA analysis software; PROGNOSIS
- Publication
Acta Oncologica, 2011, Vol 50, Issue 8, p1158
- ISSN
0284-186X
- Publication type
Article
- DOI
10.3109/0284186X.2011.584327