High Expression of IRS-1, RUNX3 and SMAD4 Are Positive Prognostic Factors in Stage I-III Colon Cancer.

Colon cancer is a common malignancy and a major contributor to human morbidity and mortality. In this study, we explore the expression and prognostic impact of IRS-1, IRS-2, RUNx3, and SMAD4 in colon cancer. Furthermore, we elucidate their correlations with miRs 126, 17-5p, and 20a-5p, which are identified as potential regulators of these proteins. Tumor tissue from 452 patients operated for stage I-III colon cancer was retrospectively collected and assembled into tissue microarrays. Biomarkers' expressions were examined by immunohistochemistry and analyzed using digital pathology. In univariate analyses, high expression levels of IRS1 in stromal cytoplasm, RUNX3 in tumor (nucleus and cytoplasm) and stroma (nucleus and cytoplasm), and SMAD4 in tumor (nucleus and cytoplasm) and stromal cytoplasm were related to increased disease-specific survival (DSS). In multivariate analyses, high expression of IRS1 in stromal cytoplasm, RUNX3 in tumor nucleus and stromal cytoplasm, and high expression of SMAD4 in tumor and stromal cytoplasm remained independent predictors of improved DSS. Surprisingly, with the exception of weak correlations (0.2 < r < 0.25) between miR-126 and SMAD4, the investigated markers were mostly uncorrelated with the miRs. However, weak to moderate/strong correlations (0.3 < r < 0.6) were observed between CD3 and CD8 positive lymphocyte density and stromal RUNX3 expression. High expression levels of IRS1, RUNX3, and SMAD4 are positive prognostic factors in stage I-III colon cancer. Furthermore, stromal expression of RUNX3 is associated with increased lymphocyte density, suggesting that RUNX3 is an important mediator during recruitment and activation of immune cells in colon cancer.

High expression of miR-17-5p and miR-20a-5p predicts favorable disease-specific survival in stage I-III colon cancer.

In many types of cancer, microRNAs (miRs) are aberrantly expressed. The aim of this study was to explore the prognostic impact of miR-17-5p and miR-20a-5p in colon cancer. Tumor tissue from 452 stage I-III colon cancer patients was retrospectively collected and tissue microarrays constructed. miR-17-5p and miR-20a-5p expression was evaluated by in situ hybridization and analyzed using digital pathology. Cell line experiments, using HT-29 and CACO-2, were performed to assess the effect of miR-17-5p and miR-20a-5p over expression on viability, invasion and migration. In multivariate analyses, high miR-17-5p expression in tumor (HR = 0.43, CI 0.26-0.71, p < 0.001) and high expression of miR-20a-5p in tumor (HR = 0.60, CI 0.37-0.97, p = 0.037) and stroma (HR = 0.63, CI 0.42-0.95, p = 0.027) remained independent predictors of improved disease-specific survival. In cell lines, over expression of both miRs resulted in mitigated migration without any significant effect on viability or invasion. In conclusion, in stage I-III colon cancer, high expression of both miR-17-5p and miR-20a-5p are independent predictors of favorable prognosis.

High expression of microRNA-126 relates to favorable prognosis for colon cancer patients.

miR-126 has been identified both as a tumor suppressor and an oncogene in different types of cancer. The aim of this study was to investigate the prognostic impact of miR-126-expression in colon cancer patients. Tumor tissue from 452 patients operated for stage I-III colon cancer was retrospectively collected and tissue microarrays were constructed. miR-126 expression was evaluated by in situ hybridization and analyzed using digital pathology. To isolate the compartment specific contribution of miR-126, tumor and adjacent tumor stroma were considered separately. In univariate analyses, high expression of miR-126 in tumor and stroma was related to increased disease-specific survival (p < 0.001 and p = 0.005, respectively). In multivariate analyses, high miR-126 expression in tumor remained a significant independent predictor of improved disease-specific survival (HR = 0.42, CI 0.23-0.75, p = 0.004). Within different TNM-stages there was a tendency towards the same results, but with statistically significant results in stage II only (p = 0.007). High expression of miR-126 is an independent positive prognostic factor in stage I-III colon cancer. This finding may be used to identify patients in need of adjuvant chemotherapy.