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Canadian Journal of Gastroenterology
Volume 14, Issue 9, Pages 753-760
http://dx.doi.org/10.1155/2000/149851
Original Article

Expression of Lewisa, Sialyl Lewisa, Lewisx, Sialyl Lewisx, Antigens as Prognostic Factors in Patients with Colorectal Cancer

Tohru Nakagoe,1 Kiyoyasu Fukushima,2 Atsushi Nanashima,1 Terumitsu Sawai,1 Takashi Tsuji,1 Masaaki Jibiki,1 Hiroyuki Yamaguchi,1 Toru Yasutake,1 Hiroyoshi Ayabe,1 Tatsuki Matuo,3 Yutaka Tagawa,4 and Kokichi Arisawa5

1First Department of Surgery, Nagasaki University School of Medicine, Japan
2Department of Internal Medicine, Nagasaki Prefecture Tarami Hospital, Nishisonogi, Japan
3Division of Blood Transfusion, Nagasaki University Hospital, Japan
4School of Allied Medical Science, Nagasaki University, Japan
5Department of Preventive Medicine and Health Promotion, Nagasaki University School of Medicine, Nagasaki, Japan

Received 20 December 1999; Revised 17 May 2000

Copyright © 2000 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

BACKGROUND: Altered expression of blood group-related carbohydrate antigens such as sialyl Lewis (Le)x antigen in tumours is associated with tumour progression behaviour and subsequent prognosis. However, the prognostic value of the expression of Le-related antigens in colorectal tumours remains unclear.

PURPOSE: To clarify the prognostic value of Lea, sialyl Lea, Lex and sialyl Lex expression in colorectal carcinomas as prognostic factors after surgery.

PATIENTS AND METHODS: Colorectal carcinoma samples from 101 patients with primary colorectal carcinoma who underwent surgical resection were subject to immunohistochemical analyses for Lea, sialyl Lea, Lex and sialyl Lex expression with the respective monoclonal antibodies.

RESULTS: Lea, sialyl Lea, Lex and sialyl Lex were expressed in 69 (68.3%), 73 (72.3%), 66 (65.4%) and 76 (75.3%) carcinomas, respectively. The patients with sialyl Lex-expressing tumours had more advanced cancer than those with nonsialyl Lex-expressing tumours (P=0.0029). The survival time after surgery of patients with Lex- or sialyl Lex-expressing tumours was significantly shorter than the survival time of those with non-Lex- or nonsialyl Lex-expressing tumours, respectively (P=0.023 and P=0.0001, respectively). Cox’s regression analysis revealed that Lex and sialyl Lex expression, separate from stage and histological type, were prognostic variables for patient survival (hazard ratio [HR] for sialyl Lex-positive expression to sialyl Lex-negative expression 2.90; HR for Lex-positive expression to Lex-negative expression 12.76 in stage I/IV, 0.63 in stage II and 1.69 in stage III).

CONCLUSIONS: Lex expression and sialyl Lex expression in colorectal carcinomas are each associated with poor prognosis. These variables should be considered in the design of future trials.