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2014 ; 21
(13
): 4164-73
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SMO expression in colorectal cancer: associations with clinical, pathological,
and molecular features
#MMPMID25023548
Li T
; Liao X
; Lochhead P
; Morikawa T
; Yamauchi M
; Nishihara R
; Inamura K
; Kim SA
; Mima K
; Sukawa Y
; Kuchiba A
; Imamura Y
; Baba Y
; Shima K
; Meyerhardt JA
; Chan AT
; Fuchs CS
; Ogino S
; Qian ZR
Ann Surg Oncol
2014[Dec]; 21
(13
): 4164-73
PMID25023548
show ga
BACKGROUND: Smoothened, frizzled family receptor (SMO) is an important component
of the hedgehog signaling pathway, which has been implicated in various human
carcinomas. However, clinical, molecular, and prognostic associations of SMO
expression in colorectal cancer remain unclear. METHODS: Using a database of 735
colon and rectal cancers in the Nurse's Health Study and the Health Professionals
Follow-up Study, we examined the relationship of tumor SMO expression (assessed
by immunohistochemistry) to prognosis, and to clinical, pathological, and tumor
molecular features, including mutations of KRAS, BRAF, and PIK3CA, microsatellite
instability, CpG island methylator phenotype (CIMP), LINE-1 methylation, and
expression of phosphorylated AKT and CTNNB1. RESULTS: SMO expression was detected
in 370 tumors (50 %). In multivariate logistic regression analysis, SMO
expression was independently inversely associated with phosphorylated AKT
expression [odds ratio (OR) 0.48; 95 % confidence interval (CI) 0.34-0.67] and
CTNNB1 nuclear localization (OR 0.48; 95 % CI 0.35-0.67). SMO expression was not
significantly associated with colorectal cancer-specific or overall survival.
However, in CIMP-high tumors, but not CIMP-low/0 tumors, SMO expression was
significantly associated with better colorectal cancer-specific survival
(log-rank P = 0.012; multivariate hazard ratio, 0.36; 95 % CI 0.13-0.95; P
interaction = 0.035, for SMO and CIMP status). CONCLUSIONS: Our data reveal novel
potential associations between the hedgehog, the WNT/CTNNB1, and the PI3K
(phosphatidylinositol-4,5-bisphosphonate 3-kinase)/AKT pathways, supporting
pivotal roles of SMO and hedgehog signaling in pathway networking. SMO expression
in colorectal cancer may interact with tumor CIMP status to affect patient
prognosis, although confirmation by future studies is needed.