Abstract
ObjectiveThis study aimed to investigate the clinical and prognostic relevance of B7-H3 expression and indicators of glucose metabolism in patients with colorectal cancer (CRC).MethodsUsing immunohistochemistry, the expression of B7-H3 was detected in a total of 213 formalin-fixed paraffin-embedded CRC tissue specimens. Furthermore, levels of fasting blood glucose (FBG), lactic dehydrogenase (LDH), and fructosamine (FMN) as indicators of glucose metabolism were analyzed in CRC patients and stratified into high or low expression sub-groups based on Youden Index. The relationship between B7-H3, FBG, LDH, FMN expression, and clinicopathological characteristics were also evaluated to establish their prognostic significance in patients with CRC.ResultsB7-H3 was highly expressed in CRC tissue. The positive rates of B7-H3 expression was 63.8% (136/213). We found a linear correlation between B7-H3 and FBG in depth of tumor invasion (T3/4) (p = 0.037, r = 0.259), lymph node metastasis (N0) (p = 0.004, r = 0.259), and TNM stage (I/II) (p = 0.009, r = 0.242). High expression of FBG, LDH, FMN [hazard ratio (HR) = 1.916, 95% CI: 1.223–3.00, p = 0.005; HR = 1.801, 95% CI: 1.153–2.813, p = 0.010; HR = 2.154, 95% CI: 1.336–3.472, p = 0.002], respectively, was identified as a significant independent predictor of poor overall survival (OS). Although B7-H3 expression did not affect OS, CRC patients expressing both high B7-H3 and high FMN contributed to a significant decrease in OS (HR = 1.881, 95%CI: 1.059–3.339, p = 0.031). Moreover, with low expression of B7-H3, high expression of FBG, LDH and FMN were also recognized as predictors of inferior OS (HR = 3.393, 95% CI: 1.493-7.709, p = 0.004; HR = 7.107, 95% CI: 2.785–18.138, p = 0.000; HR = 2.800, 95% CI: 1.184–6.625, p = 0.019).ConclusionB7-H3 combined with FBG, LDH, or FMN, could reflect the clinical outcomes of patients with CRC.
Highlights
Colorectal cancer (CRC) remains the third most frequently diagnosed gastrointestinal tract malignancy in men and second in women, globally
B7-H3 was highly expressed in CRC tissue
We evaluated the correlation between Overall survival (OS) and FBG, LDH, or FMN in the subgroup with different expression of B7-H3
Summary
Colorectal cancer (CRC) remains the third most frequently diagnosed gastrointestinal tract malignancy in men and second in women, globally. The mortality rate of CRC has been declining progressively, it still represents the third leading cause of cancer-associated mortality for both men and women [1] In contrast to these declines, CRC remains the most rapidly increasing cancer in China over the past few decades. Gu et al summarized tobacco smoking, alcohol abuse, obesity, low physical activity, low fruit and fiber consumption, and high intake of red and processed meat as the significant attributable causes of CRC in China [3]. These risk factors were associated with poor prognosis of CRC, in CRC patients with diabetes mellitus (DM)
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