Abstract
CD47, a transmembrane protein, is widely overexpressed on the tumor cell surface. However, the prognostic significance of CD47 expression in colorectal adenocarcinoma (CRA) has not yet been clarified. Here, we investigated the clinicopathologic significance of CD47 expression in CRA. CD47 expression was evaluated via immunohistochemical analysis of microarray sections of 328 CRA tissues. CD47 expression was observed in 53 (16.2%) of the 328 CRA tissues, and positive expression was associated with lymphatic invasion (p = 0.018), perineural invasion (p = 0.024), tumor budding (p = 0.009), the pathologic N stage (p = 0.022), and the American Joint Committee on Cancer (AJCC) stage (p = 0.027). In survival analyses of 329 patients, a positive CD47 expression was associated with a poor recurrence-free survival (RFS) (p = 0.032). In multivariate analysis, however, it was not an independent prognostic factor. In patients who underwent surgical resection without adjuvant treatment, a positive CD47 expression was associated with a shorter RFS (p = 0.001) but not with cancer-specific survival (CSS). In patients who received postoperative adjuvant treatment, no significant differences were found in both RFS and CSS. In conclusion, we investigated CD47 expression in 328 CRA tissues. A positive CD47 expression was observed in a minority (16.2%) of the tissues and was significantly associated with adverse clinicopathologic features and a poor patient outcome.
Highlights
Colorectal adenocarcinoma (CRA) is the third most common malignancy and the second leading cause of cancer-related deaths worldwide [1]
CD47 binds to signal regulator protein alpha (SIPRα), which is expressed on the surface of macrophages and inhibits phagocytosis [12]
Various immunotherapies have been investigated in human malignancies, and several breakthrough approaches, which target the innate immune system, have been discovered [27]
Summary
Colorectal adenocarcinoma (CRA) is the third most common malignancy and the second leading cause of cancer-related deaths worldwide [1]. CRA, the survival of patients with advanced CRA remains poor [2]. An accurate prediction of prognosis has become essential for determining the appropriate treatment for cancer patients [3]. Many candidate biomarkers have been investigated for the prediction of CRA prognosis and targeted therapy, the identification of effective biomarkers remains challenging [4]. Tumor development involves an interplay between cancer cells, stromal cells, and the immune system [5]. Patients with inflammatory bowel disease, such as ulcerative colitis and Crohn’s disease, have an elevated risk of developing CRA, principally resulting from the pro-neoplastic effects of chronic inflammation [7]. Tumor-associated macrophage (TAM) involves the activation and elimination of cancer cells through phagocytosis [8]
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