Wrana Friederike, Dötzer Katharina, Prüfer Martin, Werner Jens, Mayer Barbara
Department of General, Visceral, and Transplant Surgery, Ludwig-Maximilians-University, Marchioninistraße 15, 81377 Munich, Germany.
German Cancer Consortium (DKTK), Partner Site Munich, Pettenkoferstraße 8a, 80336 Munich, Germany.
Cancers (Basel). 2022 Apr 12;14(8):1939. doi: 10.3390/cancers14081939.
Considering the biology of CRC, distant metastases might support the identification of high-risk patients for early recurrence and targeted therapy. Expression of a panel of druggable, metastasis-related biomarkers was immunohistochemically analyzed in 53 liver (LM) and 15 lung metastases (LuM) and correlated with survival. Differential expression between LM and LuM was observed for the growth factor receptors IGF1R (LuM 92.3% vs. LM 75.8%, = 0.013), EGFR (LuM 68% vs. LM 41.5%, = 0.004), the cell adhesion molecules CD44v6 (LuM 55.7% vs. LM 34.9%, = 0.019) and α2β1 (LuM 88.3% vs. LM 58.5%, = 0.001) and the check point molecule PD-L1 (LuM 6.1% vs. LM 3.3%, = 0.005). Contrary, expression of HGFR, Hsp90, Muc1, Her2/neu, ERα and PR was comparable in LuM and LM. In the LM cohort ( = 52), a high CD44v6 expression was identified as an independent factor of poor prognosis (PFS: HR 2.37, 95% CI 1.18-4.78, = 0.016). High co-expression of CD44v6/α2β1 (HR 4.14, 95% CI 1.65-10.38, = 0.002) and CD44v6/PD-L1 (HR 2.88, 95% CI 1.21-6.85, = 0.017) indicated early recurrence after hepatectomy, in a substantial number of patients (CD44v6/α2β1: 11 (21.15%) patients; CD44v6/PD-L1: 12 (23.1%) patients). Dual expression of druggable protein biomarkers may refine prognostic prediction and stratify high-risk patients for new therapeutic concepts, depending on the metastatic location.
考虑到结直肠癌的生物学特性,远处转移可能有助于识别早期复发和靶向治疗的高危患者。对53例肝转移(LM)和15例肺转移(LuM)患者的一组可药物化的、与转移相关的生物标志物进行免疫组化分析,并与生存率相关联。观察到LM和LuM之间生长因子受体IGF1R(LuM为92.3%,LM为75.8%,P = 0.013)、EGFR(LuM为68%,LM为41.5%,P = 0.004)、细胞粘附分子CD44v6(LuM为55.7%,LM为34.9%,P = 0.019)和α2β1(LuM为88.3%,LM为58.5%,P = 0.001)以及检查点分子PD-L1(LuM为6.1%,LM为3.3%,P = 0.005)的表达存在差异。相反,HGFR、Hsp90、Muc1、Her2/neu、ERα和PR在LuM和LM中的表达相当。在LM队列(n = 52)中,高CD44v6表达被确定为预后不良的独立因素(无进展生存期:风险比2.37,95%置信区间1.18 - 4.78,P = 0.016)。CD44v6/α2β1(风险比4.14,95%置信区间1.65 - 10.38,P = 0.002)和CD44v6/PD-L1(风险比2.88,95%置信区间1.21 - 6.85,P = 0.017)的高共表达表明在相当数量的患者中(CD44v6/α2β1:11例(21.15%)患者;CD44v6/PD-L1:12例(23.1%)患者)肝切除术后早期复发。可药物化蛋白质生物标志物的双重表达可能会优化预后预测,并根据转移部位将高危患者分层以采用新的治疗理念。