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Decreased Er Beta Expression And High Cyclin D1 Expression May Predict Early Crc Recurrence In High-Risk Duke'S B And Duke'S C Stage

JOURNAL OF BUON(2021)

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Abstract
Purpose: Despite many known risk factors for the colorectal cancer (CRC) recurrence, significant differences in disease-free survival (DFS) impose the need to look for new explanations. This study aimed to determine the degree of expression of ER alpha, ER beta, PR, Cyclin D1, and Bcl-2 and their association with early CRC relapse.Methods: This retrospective study included 101 radically operated CRC patients in high-risk Duke's B and Duke's C stage. Tissue samples were retrieved from paraffin blocks and clinical and diagnostic data from medical records obtained during further clinical treatment and follow up. Patients were divided into DFS=24 months group and DFS=48 months group. Immunostaining of ER alpha, ER beta, PR, Cyclin D1, and Bcl-2 was performed and analyzed.Results: ERa was not expressed in all patients. ER beta moderate expression was present in 25% of all patients, more often in the DFS=48 group (p=0.001). PR and Bcl-2 showed only moderate expression in 1/5 and 1/3 of the patients, respectively, without significant difference between groups (p=0.145; p=0.566). Cyclin D1 was expressed in the whole sample of patients with strong expression statistically more often in DFS <= 24 group (p=0.011) and had 5.2 higher odds of having DFS<24 months. Moderate expression of ER beta was joined with 79.2% smaller odds for shorter DFS. Advanced T stage had 11.3 times higher odds of having DFS<24 months.Conclusion: Early recurrence of CRC in high-risk Duke's B and Duke's C stage relates with reduced ER beta expression and the high cyclin D1 expression, so they could be considered independent prognostic factors, especially in patients in advanced T stage.
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Key words
colorectal cancer, early recurrence, ER beta, Cyclin D1
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