Downregulated P1 promoter-driven hepatocyte nuclear factor-4alpha expression in human colorectal carcinoma is a new prognostic factor against liver metastasis

Liver metastases are the most critical prognostic factors for patients with colorectal carcinomas (CRC). It has been reported that the dysregulation of hepatocyte nuclear factor-4alpha (HNF4alpha) expression is linked to the development of CRC, gastric cancer and hepatocellular carcinoma. The purpose of the present paper was to examine the P1 and P2 promoter-driven HNF4alpha (P1 and P2) expression in surgically resected CRC. Immunohistochemically, P1, P2, MUC1 and CD10 expression were evaluated in 63 cases of primary CRC. Positive staining with P1, P2, MUC1 and CD10 antibodies were observed in 37 (59%), 63 (100%), 42 (67%) and 27 (43%) cases, respectively. Loss or decreased P1 expression was observed with respect to the depth of the tumor invasion. The frequency of P1-positive expression in Dukes' C and D tumors was significantly lower than that in Dukes' A and B tumors. There was a relationship between the loss of P1 expression and metachronous liver metastases, and the survival rate of the P1-negative patients without liver metastasis at the time of the primary CRC resection tended to be worse than that of the P1-positive patients. These findings suggest that downregulation of P1 expression is involved in tumor metastasis and a worse prognosis.

Phenotypic expression of gastrointestinal differentiation markers in colorectal adenocarcinomas with liver metastasis

AIM

The purpose of the present study was to clarify the correlation between phenotypic expression of gastrointestinal differentiation markers and colorectal cancer behaviour, particularly invasion and hepatic metastasis.

METHODS

Thirty-one cases of advanced colorectal adenocarcinoma (CRC) with liver metastasis were selected. Phenotypic patterns were evaluated immunohistochemically by means of antibodies to CD10, MUC2, and human gastric mucin (HGM).

RESULTS

The incidence of MUC2 (45.2%) and HGM (16.1%) expression in CRCs with liver metastasis did not differ from non-metastatic CRCs. In contrast, the incidence of CD10 expression was significantly higher in CRCs with liver metastasis (58.1%) than in control CRCs (21.7%). Phenotypic expression in the liver metastasis carcinomas was similar to that of the primary lesions.

CONCLUSIONS

The findings suggest that cases of CRC with CD10 expression are at increased risk of liver metastasis. Even if there is no liver metastasis at laparotomy for CRC, careful follow-up is recommended for CRCs with CD10 expression.