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Ooi LC, Ho V, Zhu JZ, Lim S, Chung L, Abubakar A, Rutland T, Chua W, Ng W, Lee M, Morgan M, MacKenzie S, Lee CS. p21 as a Predictor and Prognostic Indicator of Clinical Outcome in Rectal Cancer Patients. Int J Mol Sci 2024; 25:725. [PMID: 38255799 PMCID: PMC10815780 DOI: 10.3390/ijms25020725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/25/2023] [Accepted: 01/03/2024] [Indexed: 01/24/2024] Open
Abstract
The cell cycle plays a key and complex role in the development of human cancers. p21 is a potent cyclin-dependent kinase inhibitor (CDKI) involved in the promotion of cell cycle arrest and the regulation of cellular senescence. Altered p21 expression in rectal cancer cells may affect tumor cells' behavior and resistance to neoadjuvant and adjuvant therapy. Our study aimed to ascertain the relationship between the differential expression of p21 in rectal cancer and patient survival outcomes. Using tissue microarrays, 266 rectal cancer specimens were immunohistochemically stained for p21. The expression patterns were scored separately in cancer cells retrieved from the center and the periphery of the tumor; compared with clinicopathological data, tumor regression grade (TRG), disease-free, and overall survival. Negative p21 expression in tumor periphery cells was significantly associated with longer overall survival upon the univariate (p = 0.001) and multivariable analysis (p = 0.003, HR = 2.068). Negative p21 expression in tumor periphery cells was also associated with longer disease-free survival in the multivariable analysis (p = 0.040, HR = 1.769). Longer overall survival times also correlated with lower tumor grades (p= 0.011), the absence of vascular and perineural invasion (p = 0.001; p < 0.005), the absence of metastases (p < 0.005), and adjuvant treatment (p = 0.009). p21 expression is a potential predictive and prognostic biomarker for clinical outcomes in rectal cancer patients. Negative p21 expression in tumor periphery cells demonstrated significant association with longer overall survival and disease-free survival. Larger prospective studies are warranted to investigate the ability of p21 to identify rectal cancer patients who will benefit from neoadjuvant and adjuvant therapy.
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Affiliation(s)
- Li Ching Ooi
- Department of Anatomical Pathology, Liverpool Hospital, Liverpool, NSW 2170, Australia; (L.C.O.); (J.Z.Z.); (T.R.); (C.S.L.)
| | - Vincent Ho
- School of Medicine, Western Sydney University, Penrith, NSW 2751, Australia; (L.C.); (A.A.); (W.C.); (S.M.)
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia;
| | - Jing Zhou Zhu
- Department of Anatomical Pathology, Liverpool Hospital, Liverpool, NSW 2170, Australia; (L.C.O.); (J.Z.Z.); (T.R.); (C.S.L.)
| | - Stephanie Lim
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia;
- Macarthur Cancer Therapy Centre, Campbelltown Hospital, Campbelltown, NSW 2560, Australia
- Discipline of Medical Oncology, School of Medicine, Western Sydney University, Liverpool, NSW 2170, Australia
| | - Liping Chung
- School of Medicine, Western Sydney University, Penrith, NSW 2751, Australia; (L.C.); (A.A.); (W.C.); (S.M.)
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia;
| | - Askar Abubakar
- School of Medicine, Western Sydney University, Penrith, NSW 2751, Australia; (L.C.); (A.A.); (W.C.); (S.M.)
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia;
| | - Tristan Rutland
- Department of Anatomical Pathology, Liverpool Hospital, Liverpool, NSW 2170, Australia; (L.C.O.); (J.Z.Z.); (T.R.); (C.S.L.)
- School of Medicine, Western Sydney University, Penrith, NSW 2751, Australia; (L.C.); (A.A.); (W.C.); (S.M.)
- Discipline of Pathology, School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia
| | - Wei Chua
- School of Medicine, Western Sydney University, Penrith, NSW 2751, Australia; (L.C.); (A.A.); (W.C.); (S.M.)
- Discipline of Medical Oncology, School of Medicine, Western Sydney University, Liverpool, NSW 2170, Australia
- Department of Medical Oncology, Liverpool Hospital, Liverpool, NSW 2170, Australia;
| | - Weng Ng
- Department of Medical Oncology, Liverpool Hospital, Liverpool, NSW 2170, Australia;
| | - Mark Lee
- Department of Radiation Oncology, Liverpool Hospital, Liverpool, NSW 2170, Australia;
| | - Matthew Morgan
- Department of Colorectal Surgery, Liverpool Hospital, Liverpool, NSW 2170, Australia;
| | - Scott MacKenzie
- School of Medicine, Western Sydney University, Penrith, NSW 2751, Australia; (L.C.); (A.A.); (W.C.); (S.M.)
- Department of Colorectal Surgery, Liverpool Hospital, Liverpool, NSW 2170, Australia;
| | - Cheok Soon Lee
- Department of Anatomical Pathology, Liverpool Hospital, Liverpool, NSW 2170, Australia; (L.C.O.); (J.Z.Z.); (T.R.); (C.S.L.)
- School of Medicine, Western Sydney University, Penrith, NSW 2751, Australia; (L.C.); (A.A.); (W.C.); (S.M.)
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia;
- Discipline of Pathology, School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia
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Peng L, Tang Y, Zhang Y, Guo S, Peng L, Ye L, Wang Y, Jiang Y. Structural maintenance of chromosomes 4 is required for leukemia stem cell maintenance in MLL-AF9 induced acute myeloid leukemia. Leuk Lymphoma 2017; 59:2423-2430. [PMID: 29043883 DOI: 10.1080/10428194.2017.1387906] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The gene, structural maintenance of chromosomes 4 (SMC4) plays important role in chromosomes condensing and mitotic sister chromatid segregation, which has been revealed in regulating multiple cancer development and carcinogenesis. However, the role of SMC4 in acute myeloid leukemia (AML) propagation and its function in regulation of leukemia stem cells (LSCs) is not yet clear. Using an MLL-AF9 induced AML mouse model, we demonstrated that down modulating of SMC4 expression could prolong the survival time of AML mice. Furthermore, we found that knockdown SMC4 expression decreased the proportion of LSCs and affected its leukemia-initiating capacity. Cell cycle assay demonstrated that more LSCs were arrested in G0 phase by SMC4 knockdown. This activity was accompanied by increased expression of the Cdkn1a (P21) and Cdkn1b (P27) as well as decreased expression of CDK4. Therefore, our study revealed the critical role of SMC4 during AML progression and provided new insights into the mechanism of LSC maintenance.
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Affiliation(s)
- Luyun Peng
- a Department of Laboratory Medicine , West China Second University Hospital, Sichuan University , Chengdu , China.,b Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education , Chengdu , China
| | - Yuanting Tang
- a Department of Laboratory Medicine , West China Second University Hospital, Sichuan University , Chengdu , China.,b Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education , Chengdu , China
| | - Yingchi Zhang
- c State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital , Chinese Academy of Medical Sciences and Peking Union Medical College , Tianjin , China
| | - Siqi Guo
- a Department of Laboratory Medicine , West China Second University Hospital, Sichuan University , Chengdu , China.,b Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education , Chengdu , China
| | - Leiwen Peng
- a Department of Laboratory Medicine , West China Second University Hospital, Sichuan University , Chengdu , China.,b Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education , Chengdu , China
| | - Lei Ye
- a Department of Laboratory Medicine , West China Second University Hospital, Sichuan University , Chengdu , China.,b Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education , Chengdu , China
| | - Yuefang Wang
- a Department of Laboratory Medicine , West China Second University Hospital, Sichuan University , Chengdu , China.,b Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education , Chengdu , China
| | - Yongmei Jiang
- a Department of Laboratory Medicine , West China Second University Hospital, Sichuan University , Chengdu , China.,b Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education , Chengdu , China
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