Abstract

BackgroundThe development and progression of colorectal cancer (CRC) involve a complex process of multiple genetic changes. Tumor suppressor p53 is capable of determining the fate of CRC cells. However, the role of a p53-inducible modulator, ribosomal protein S27-like (RPS27L), in CRC is unknown.MethodsHere, the differential expression of RPS27L was examined in the feces and colonic tissues of CRC patients, to explore its possible correlation with patient survival and to investigate the cellular mechanisms underlying their clinical outcomes. Eighty intermediate-stage CRC patients (42 at stage II and 38 at stage III) were divided into two groups according to their fecal RPS27L mRNA levels. The survival probabilities of the groups were estimated using the Kaplan–Meier method. The RPS27L protein in the colonic tissues of stage III patients with different prognoses was further examined immunohistochemically. RPS27L expression in LoVo cells was manipulated to examine the possible cellular responses in vitro.ResultsElevated RPS27L expression, in either feces or tissues, was related to a better prognosis. In vitro, RPS27L-expressing LoVo cells ceased DNA synthesis and apoptotic activity while the expression of their DNA repair molecules was upregulated.ConclusionsElevated RPS27L may improve the prognoses of certain CRC patients by enhancing the DNA repair capacity of their colonic cells, and can be determined in feces. By integrating clinical, molecular, and cellular data, our study demonstrates that fecal RPS27L may be a useful index for predicting prognoses and guiding personalized therapeutic strategies, especially in patients with intermediate-stage CRC.

Highlights

  • The development and progression of colorectal cancer (CRC), one of the most common fatal cancers, involve a complex process of multiple genetic changes [1,2]

  • We performed a receiver operating characteristic (ROC) curve analysis and stratified the patients into two groups using the fecal ribosomal protein S27-like (RPS27L) level of 0.0014, for which a sensitivity of 0.80 (95% confidence interval [CI], 0.28–0.99) and a specificity of 0.77 were achieved, to predict the prognosis of patients

  • The survival rates were compared between the RPS27L+ (n = 51; $ 0.0014) and RPS27L2 groups (n = 20;,0.0014); the five-year disease-specific survival (DSS) rate was higher in the RPS27L+ group (97.1% 62.8%) than in the RPS27L2 group (69.6% 612.9%; P = 0.028, log-rank test)

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Summary

Introduction

The development and progression of colorectal cancer (CRC), one of the most common fatal cancers, involve a complex process of multiple genetic changes [1,2]. Surgery is the optimal treatment for CRC patients at stages II and III, but adjuvant chemotherapy has improved the prognosis for some of these intermediate-stage patients [3]. The detection of alterations in expression of p53-responsive genes has been suggested to allow identification of patients at high risk of recurrence and those who should be considered for adjuvant chemotherapy [9]. The development and progression of colorectal cancer (CRC) involve a complex process of multiple genetic changes. Tumor suppressor p53 is capable of determining the fate of CRC cells. The role of a p53-inducible modulator, ribosomal protein S27-like (RPS27L), in CRC is unknown

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