Department of Medical Genetics, College of Basic Medical Sciences, Second Military Medical University, Changhai Hospital, Shanghai, PR China.
J Clin Gastroenterol. 2009 Oct;43(9):831-7. doi: 10.1097/MCG.0b013e31819cc731.
To gain an insight into the putative role of annexin A5 (ANXA5) in the tumor stage and its clinical outcome.
ANXA5 is a calcium-binding protein, which has been implicated in the carcinogenesis of several carcinomas. However, the role of ANXA5 in colorectal cancer (CRC) is unclear.
We investigated the expression of ANXA5 in colorectal adenocarcinoma. This study included 207 consecutive patients with sporadic CRC. Paired colorectal tissue samples and corresponding nonmalignant tissues were obtained by surgical resection. ANXA5 mRNA and protein expression in each tissue were assessed by real-time reverse transcriptase polymerase chain reaction (RT-PCR) and immunohistochemical staining. Data were statistically correlated with pathologic parameters and clinical outcome.
Real-time reverse transcriptase polymerase chain reaction showed that there is an up-regulation in the mRNA level of ANXA5 in tumors (P<0.001). Immunohistochemical study revealed that high ANXA5 expression was present in 40.58% (84 of 207) of tumors. Univariate analysis showed increased ANXA5 expression correlated with pT stage (P=0.008), liver metastasis (P=0.024), pathologic tumor-node-metastasis stage (P=0.015), Dukes' stage (P=0.017), recurrence (P=0.024), cancer-related death (P=0.028), recurrence-free probability (P=0.003), and overall survival (P=0.005). Multivariate analysis showed that ANXA5 expression and liver metastasis significantly correlated with recurrence-free probability (P=0.039 and P=0.048, respectively) and overall survival (P=0.012 and P=0.021, respectively) independent of pT stage and pN stage.
From these findings ANXA5 expression seems to be related to the tumor stage and clinical outcome of CRC. Thus ANXA5 could serve as a prognostic marker for tumor progression.
深入了解膜联蛋白 A5（ANXA5）在肿瘤分期中的假定作用及其临床结局。
ANXA5 是一种钙结合蛋白，已被牵连到几种癌的癌变过程中。然而，ANXA5 在结直肠癌（CRC）中的作用尚不清楚。
我们研究了 ANXA5 在结直肠腺癌中的表达。本研究纳入了 207 例连续的散发性 CRC 患者。通过手术切除获得配对的结直肠组织样本和相应的非恶性组织。通过实时逆转录聚合酶链反应（RT-PCR）和免疫组织化学染色评估每个组织中的 ANXA5 mRNA 和蛋白表达。数据与病理参数和临床结局进行统计学关联。
实时 RT-PCR 显示肿瘤中 ANXA5 的 mRNA 水平上调（P<0.001）。免疫组织化学研究显示，84 例（40.58%）肿瘤中存在高 ANXA5 表达。单因素分析显示，ANXA5 表达增加与 pT 分期（P=0.008）、肝转移（P=0.024）、病理肿瘤-淋巴结-转移分期（P=0.015）、Dukes 分期（P=0.017）、复发（P=0.024）、癌症相关死亡（P=0.028）、无复发生存率（P=0.003）和总生存率（P=0.005）相关。多因素分析显示，ANXA5 表达和肝转移与无复发生存率（P=0.039 和 P=0.048）和总生存率（P=0.012 和 P=0.021）显著相关，独立于 pT 分期和 pN 分期。
从这些发现中，ANXA5 的表达似乎与 CRC 的肿瘤分期和临床结局有关。因此，ANXA5 可以作为肿瘤进展的预后标志物。
