Livin expression is an independent factor in rectal cancer patients with or without preoperative radiotherapy

Zhen-Yu Ding,Xiao-Feng Sun,Hong Zhang,Gunnar Adell,Birgit Olsson

doi:10.1186/1748-717x-8-281

Abstract

BackgroundThis study was aimed to investigate the expression significance of Livin in relation to radiotherapy (RT), clinicopathological and biological factors of rectal cancer patients.MethodsThis study included 144 primary rectal cancer patients who participated in a Swedish clinical trial of preoperative radiotherapy. Tissue microarray samples from the excised primary rectal cancers, normal mucosa and lymph node metastases were immunostained with Livin antibody. The proliferation of colon cancer cell lines SW620 and RKO was assayed after Livin knock-down.ResultsThe expression of Livin was significantly increased from adjacent (P = 0.051) or distant (P = 0.028) normal mucosa to primary tumors. 15.4% (2/13) and 39.7% (52/131) patients with Livin-negative and positive tumors died at 180 months after surgery, and the difference tended to be statistically significant (P = 0.091). In multivariate analyses, the difference achieved statistical significance, independent of TNM stage, local and distant recurrence, grade of differentiation, gender, and age (odds ratio = 5.09, 95% CI: 1.01-25.64, P = 0.048). The in vitro study indicated colon cancer cells with Livin knock-down exhibited decreased proliferation compared with controls after RT.ConclusionsThe expression of Livin was was independently related to survival in rectal cancer patients, suggesting Livin as a useful prognostic factor for rectal cancer patients.

Highlights

This study was aimed to investigate the expression significance of Livin in relation to radiotherapy (RT), clinicopathological and biological factors of rectal cancer patients
We investigated the relationships of Livin expression to radiotherapy and to clinicopathologic or biologic variables in Colorectal cancer (CRC) patients who participated in a clinical trial of preoperative radiotherapy
Livin expression in normal mucosa, primary tumor and lymph node metastasis By immunostaining, Livin expression was predominantly detected in the cytoplasm of epithelial cells of normal mucosa, and tumor cells of primary cancers and lymph node metastases, with little staining in the nuclei (Figure 1A and Additional file 1)

Summary

Introduction

This study was aimed to investigate the expression significance of Livin in relation to radiotherapy (RT), clinicopathological and biological factors of rectal cancer patients. Colorectal cancer (CRC) is one of the leading causes of cancer death in Western countries [1,2]. Surgery remains the curative modality for the CRC, and preoperative radiotherapy (RT) has shown a survival advantage compared with surgery alone. The value of preoperative RT still remains controversial [3,4,5]. There is an urgent need to search for predictive indicators to identify patients who can be benefited from preoperative radiotherapy. Many molecules that participate the biological process of proliferation and apoptosis have been proposed as potential indicators for RT. We have previously reported that Survivin from the Inhibitor of Apoptosis (IAP)

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