The prognostic role of mismatch repair status and CDX-2 expression with inflammatory markers and pathological risk factors in stage ıı and ııı colon cancer: Multicenter real-life data

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dc.authorid0000-0002-0077-6971
dc.authorid0000-0002-2901-4671
dc.authorid0000-0003-2715-4002
dc.authorid0000-0001-8802-6376
dc.authorid0000-0002-5823-1704
dc.authorid0000-0002-8610-768X
dc.contributor.authorAydın, Sabin Göktaş
dc.contributor.authorÖlmez, Ömer Fatih
dc.contributor.authorSelvi, Oğuzhan
dc.contributor.authorGeredeli, Çağlayan
dc.contributor.authorÖzden, Ferhat
dc.contributor.authorBilici, Ahmet
dc.contributor.authorAçıkgöz, Özgür
dc.contributor.authorKarcı, Ebru
dc.contributor.authorKutlu, Yasin
dc.contributor.authorHamdard, Jamshid
dc.contributor.authorAydın, Ahmet
dc.date.accessioned2024-06-04T11:55:51Z
dc.date.available2024-06-04T11:55:51Z
dc.date.issued2024
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Tıbbi Patoloji Ana Bilim Dalı
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, İç Hastalıkları Ana Bilim Dalı
dc.description.abstractObjective: Colorectal cancer is common worldwide, and adjuvant treatment’s benefit is still controversial. We designed this study to determine the role of MSI and CDX-2 status determined by immunohistochemistry (IHC) combined with the inflammatory markers and pathological parameters in predicting disease recurrence in stage II and III colon cancer. Methods: A total of 226 stage II/III colon cancer patients with a median age of 59 years who underwent initial surgery were included in this retrospective study. The pathologic assessment of MSI and CDX-2 was performed twice by immunohistochemistry (IHC) and two different pathologists. No staining/weak staining below 10% of the tumor was accepted as CDX-2 negative, and any MSI clones with weak staining below 10% were accepted as MSI-H. The laboratory parameters were noted at the initial diagnosis. Results: One hundred twenty-one and 105 patients were diagnosed with stage III and II colon cancer. 58.0% of patients were male, 46 (20.4%) of tumor tissue were MSS, and 17 (7.5%) were CDX-2 negative. One hundred twenty-nine tumors were localized in the right colon. Disease recurrence was significantly correlated with tumor localization, CDX-2 status, stage at diagnosis, and preoperatively median CRP and CEA levels. DFS rates for MSS patients with CDX-2 negative and positive were 36.7% and 98.1%, respectively [p < 0.001]. There was no significant correlation between MSI status and CDX-2 status. MSI status, the presence of adjuvant treatment, and systemic inflammatory markers were not significant prognostic factors for DFS. CDX-2 status [HR:0.08, CI 95% 0.03–0.17, p < 0.001 HR: 1.7, CI 95% 1.1–3.0, p = 0.03], disease stage [HR:2.6, CI 95% 1.43–4.74], and preoperatively CEA levels [HR:4.1 CI 95% 2.18–785, p < 0.001 were independent significant prognostic factors for DFS. Conclusion: CDX-2 loss was an independent prognostic factor for DFS and disease recurrence in early-stage colon cancer. MSS patients with CDX-2 loss had significantly worse survival outcomes, and this might be the reason for deciding on adjuvant chemotherapy.
dc.identifier.citationAydın, S. G., Ölmez, Ö. F., Selvi, O., Geredeli, Ç., Özden, F., Bilici, A. ... Aydın, A. (2024). The prognostic role of mismatch repair status and CDX-2 expression with inflammatory markers and pathological risk factors in stage ıı and ııı colon cancer: Multicenter real-life data. Journal of Gastrointestinal Cancer, 55(1), 227-236. http://dx.doi.org/10.1007/s12029-023-00953-0
dc.identifier.doi10.1007/s12029-023-00953-0
dc.identifier.endpage236
dc.identifier.issn1941-6628
dc.identifier.issn1941-6636
dc.identifier.issue1
dc.identifier.pmid37347353
dc.identifier.scopus2-s2.0-85162997296
dc.identifier.scopusqualityQ3
dc.identifier.startpage227
dc.identifier.urihttp://dx.doi.org/10.1007/s12029-023-00953-0
dc.identifier.urihttps://hdl.handle.net/20.500.12511/12563
dc.identifier.volume55
dc.identifier.wos001014471300001en_US
dc.identifier.wosqualityN/A
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorGöktaş Aydın, Sabin
dc.institutionauthorÖlmez, Ömer Fatih
dc.institutionauthorÖzden, Ferhat
dc.institutionauthorBilici, Ahmet
dc.institutionauthorAçıkgöz, Özgür
dc.institutionauthorKarcı, Ebru
dc.institutionauthorKutlu, Yasin
dc.institutionauthorHamdard, Jamshid
dc.institutionauthorAydın, Ahmet
dc.language.isoen
dc.relation.ispartofJournal of Gastrointestinal Canceren_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectCDX-2
dc.subjectColon Cancer
dc.subjectDisease-Free Survival
dc.subjectInflammatory Marker
dc.subjectMSI
dc.titleThe prognostic role of mismatch repair status and CDX-2 expression with inflammatory markers and pathological risk factors in stage ıı and ııı colon cancer: Multicenter real-life data
dc.typeArticle

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