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Br J Cancer. 2019 May;120(10):996-1002. doi: 10.1038/s41416-019-0442-5. Epub 2019 Apr 19.

LGR5 expression predicts peritoneal recurrence after curative resection of primary colon cancer.

Author information

1
Department of Surgical Oncology, The University of Tokyo, Tokyo, Japan. hinagata-tky@umin.ac.jp.
2
Department of Surgical Oncology, The University of Tokyo, Tokyo, Japan.
3
Department of Pathology, The University of Tokyo, Tokyo, Japan.

Abstract

BACKGROUND:

The aim of this study was to clarify whether a cancer stem cell marker could be an indicator of post-operative peritoneal recurrence of colon cancer.

METHODS:

Expression of four putative markers (CD133, CD44 variant 6, aldehyde dehydrogenase-1 and leucine-rich repeating G-protein-coupled receptor-5 (LGR5)) was evaluated immunohistochemically in primary tumour samples from 292 patients who underwent curative resection for non-metastasised pT4 colon cancer at the University of Tokyo Hospital between 1997 and 2015.

RESULTS:

Peritoneal recurrence was significantly higher in LGR5-negative cases (5-year cumulative incidence: 27.5% vs. 14.4%, p = 0.037). Multivariable analysis confirmed that negative LGR5 expression was an independent risk factor for peritoneal recurrence (hazard ratio (HR) 2.79, p = 0.005) in addition to poor differentiation, positive lymph node metastasis, preoperative carcinoembryonic antigen > 5 ng/mL and anastomotic leakage. The addition of LGR5 significantly improved the predictive value of the multivariable model (net reclassification improvement: 0.186, p = 0.028: integrated discrimination improvement: 0.047, p = 0.008).

CONCLUSIONS:

Negative LGR5 expression was a significant predictor of peritoneal recurrence in patients with pT4 colon cancer. Therefore, LGR5 might be a promising biomarker to identify patients at high risk of post-operative peritoneal metastasis.

PMID:
31000786
DOI:
10.1038/s41416-019-0442-5

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