Epithelial-Mesenchymal Transition Phenotype, Metformin, and Survival for Colorectal Cancer Patients with Diabetes Mellitus II.

OBJECTIVES

We aimed to explore the association between metformin treatment and epithelial-mesenchymal transition (EMT) phenotype and further appraise the prognostic values of metformin and EMT markers E-cadherin and vimentin for colorectal cancer (CRC) in clinical practice.

METHODS

We collected specimens and evaluated clinicopathological parameters of 102 stage I to III CRC patients with prediagnosed type 2 diabetes mellitus (DM II). Expression of E-cadherin and vimentin in tumors was detected by immunohistochemistry (IHC), and statistical analysis was performed using SPSS 19.0.

RESULTS

In correlation tests, we found a lower tumor cell EMT degree (more E-cadherin ( = 0.014) and less vimentin ( = 0.011) expression in patients who used metformin, and the expression of E-cadherin and vimentin was associated with serum CA19-9 ( = 0.048, = 0.009), tumor invasive depth (T) ( < 0.001, = 0.045), and lymph invasion (N) ( = 0.013, = 0.001). In Cox multivariate regression analysis, E-cadherin was identified as a prognostic factor for disease-free survival (DFS) ( = 0.038) and metformin use ( = 0.015 = 0.044) and lymph invasion ( = 0.016 = 0.023) were considered as the prognostic factors for both DFS and overall survival (OS).

CONCLUSION

Our study suggested that metformin may impede the EMT process and improve survival for stage I-III CRC patients with DM II.