Loss of E-cadherin and MUC2 Expressions Correlated with Poor Survival in Patients with Stages II and III Colorectal Carcinoma

With the recent development of molecular markers, it has become possible to characterize colorectal carcinomas beyond clinical and histologic aspects. When considered together with tumor stage, molecular markers will allow us further insight into individual tumor biologies and prognoses. To investigate the expression and prognostic implications of the molecular markers, p53, bcl-2, Rb, hMLH1, hMSH2, beta-catenin, E-cadherin, and MUC-2. We analyzed the clinical, histologic, and molecular factors for 229 patients with colorectal carcinoma of stage II and III and compared their prognoses. We used tissue microarrays to analyze the expressions of molecular markers and to assess their correlations with prognosis. Semiquantitative expressions of molecular markers and clinicopathologic parameters were analyzed with respect to prognosis. Among the clinicopathologic parameters, left-sided location, age older than 70 years, higher preoperative serum carcinoembryonic antigen (CEA) level (a parts per thousand currency sign 5 ng/mL), irregular growth pattern, and perineural invasion were significantly related to poor prognosis in stage II and III patients. For molecular factors, loss of expression of E-cadherin and MUC-2 showed significant correlation with poor overall survival in both cancer stages. Multivariate analysis showed that higher TNM stage, higher preoperative serum CEA level (a parts per thousand currency sign 5 ng/mL), perineural tumor cell invasion, and loss of E-cadherin and MUC-2 expressions were independently correlated with poor overall survival. Our results indicated that of the analyzed molecular markers, MUC-2 and E-cadherin might be useful in predicting prognosis and planning for adjuvant therapy in patients with stage II and III colorectal carcinomas.