|Nuclear β-catenin accumulation as a prognostic factor in Dukes' D human colorectal cancers|
Authors: Shin'ichi Miyamoto, Yasushi Endoh, Takahiro Hasebe, Genichiro Ishii, Keiji Kodama, Masato Goya, Masato Ono, Norio Saitoh, Tsutomu Chiba, Atsushi Ochiai
Pathology Division, National Cancer Center Research Institute East, Kashiwa, Chiba 277-8577, Japan
β-catenin is well recognized to play a crucial role as a transcriptional factor during the early step of colorectal carcinogenesis. Some reports concerning the clinical implications of cytoplasmic and/or nuclear β-catenin accumulation are available, though their results vary. On the other hand, the clinical implication of nuclear accumulation of β-catenin in Dukes' D colorectal cancers (with distant metastasis) has not been investigated. To assess its value as a prognostic marker in this stage, we selected the cases with synchronous liver metastasis. Thirty-eight surgically resected primary and corresponding metastatic liver tumors were examined immunohistochemically and the relationships between nuclear β-catenin accumulation and clinicopathological variables were analyzed. Of the 38 primary colorectal cancers analyzed, 11 (29%) showed nuclear accumulation of β-catenin with cytoplasmic staining. Nuclear accumulation positivity was more frequently associated with lymph node metastasis than being negative [100% (11/11) vs. 67% (18/27), p=0.04]. There was a significant difference in median survival time between the nuclear β-catenin positive group (1130 days) and the negative group (2102 days: p=0.037). Interestingly, all of the patients (9/9) in the former group had died when the recurrence was in the liver, while 42% (8/19) in the latter group had survived even if the recurrence was in the liver (p=0.03). In conclusion, though these results were obtained in a small series of patients, nuclear accumulation of β-catenin may be a useful prognostic marker even in Dukes' D colorectal cancers.