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Prognostic impact of histological categorisation of epithelial-mesenchymal
transition in colorectal cancer
#MMPMID25247323
Ueno H
; Shinto E
; Kajiwara Y
; Fukazawa S
; Shimazaki H
; Yamamoto J
; Hase K
Br J Cancer
2014[Nov]; 111
(11
): 2082-90
PMID25247323
show ga
BACKGROUND: The crosstalk between cancer cells and stroma is involved in the
acquired capability for metastasis through the induction of
epithelial-mesenchymal transition (EMT). We aimed to clarify the prognostic value
of the histological category of EMT in colorectal cancer (CRC). METHODS: Tumour
EMT was graded into one of three histological categories on the basis of
integrated assessment of poorly differentiated clusters and pro-EMT desmoplasia
at the leading edge of the primary tumour (Histology(EMT)). Stage II and III CRC
patients (cohort 1, N=500) and stage IV patients (cohort 2, N=196) were
retrospectively analysed. RESULTS: In cohort 1, patients were stratified into
three groups with widely different disease-free survival rates (95%, 83% and 39%)
on the basis of Histology(EMT) (P<0.0001). In cohort 2, Histology(EMT)
significantly stratified overall survival of patients irrespective of
metasectomy. Multivariate analyses indicated that Histology(EMT) had a strong
prognostic impact independent of staging factors. Statistically, Histology(EMT)
had a better prognostic stratification power than T and N stages; however, in
cohort 2, the power of M substage was superior. CONCLUSIONS: A histological model
to categorise EMT by integrated assessment of dedifferentiation and desmoplastic
environment is a potent prognostic index independent of staging factors.
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