Combination of three-gene immunohistochemical panel and magnetic resonance imaging-detected extramural vascular invasion to assess prognosis in non-advanced rectal cancer patients

• Published in: World journal of gastroenterology : WJG 2016-10, Vol.22 (38), p.8576-8583
• Main Authors: Li, Xiao-Fu, Jiang, Zheng, Gao, Ying, Li, Chun-Xiang, Shen, Bao-Zhong
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; cancer; Magnetic; Carcinoma - blood supply; Carcinoma - diagnostic imaging; Carcinoma - pathology; Female; Humans; Image Processing, Computer-Assisted; imaging; Prognosis; Immunohistochemistry; Extramural; Immunohistochemistry - methods; invasion; Magnetic Resonance Imaging - methods; Male; Middle Aged; Neoplasm Invasiveness; Neoplasm Staging; Prognosis; Proliferating Cell Nuclear Antigen - metabolism; Proto-Oncogene Proteins c-myc - metabolism; Rectal; Rectal Neoplasms - blood supply; Rectal Neoplasms - diagnostic imaging; Rectal Neoplasms - pathology; resonance; Retrospective Studies; Retrospective Study; Tissue Inhibitor of Metalloproteinase-1 - metabolism; vascular; Young Adult
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v22.i38.8576

AIM To identify a small, clinically applicable immunohistochemistry(IHC) panel that could be combined with magnetic resonance imaging(MRI)-detected extramural vascular invasion(EMVI) for assessment of prognosis concerning the non-advanced rectal cancer patients prior to operation.METHODS About 329 patients with pathologically confirmed rectal carcinoma(RC) were screened in this research, all of whom had been examined via an MRI and were treatment-na?ve from July 2011 to July 2014. The candidate proteins that were reported to be altered by RC were examined in tissues by IHC. All chosen samples were adopted from the fundamental cores of histopathologically confirmed carcinomas during the initial surgeries.RESULTS Of the three proteins that were tested, c-MYC, PCNA and TIMP1 were detected with relatively significant expression in tumors, 35.9%, 23.7% and 58.7% respectively. The expression of the three proteins were closely connected with prognosis(P = 0.032, 0.003, 0.021). The patients could be classified into different outcome groups according to an IHC panel(P < 0.01) via these three proteins. Taking into consideration known survival covariates, especially EMVI, the IHC panel served as an independent prognostic factor. The EMVI combined with the IHC panel could categorize patients into different prognostic groups with distinction(P < 0.01).CONCLUSION These studies argue that this three-protein panel of c-MYC, PCNA, coupled with TIMP1 combined with MRIdetected EMVI could offer extra prognostic details for preoperative treatment of RC.