Copyright
©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Evaluation of clinical significance of claudin 7 and construction of prognostic grading system for stage II colorectal cancer
Ji-Chuan Quan, Jian Peng, Xu Guan, Zheng Liu, Zheng Jiang, Hai-Peng Chen, Meng Zhuang, Song Wang, Peng Sun, Hong-Ying Wang, Shuang-Mei Zou, Xi-Shan Wang
Ji-Chuan Quan, Xu Guan, Zheng Liu, Zheng Jiang, Hai-Peng Chen, Meng Zhuang, Xi-Shan Wang, Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Jian Peng, Hong-Ying Wang, State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Song Wang, Peng Sun, Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, Heilongjiang Province, China
Shuang-Mei Zou, Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Author contributions: Quan JC wrote the manuscript; Wang HY, Zou SM and Wang XS conceived of and designed the study and contributed equally; Guan X, Zhuang M, Wang S, Chen HP, Liu Z and Sun P collected the data; Quan JC, Peng J and Jiang Z analyzed the data; all authors made critical revisions for the manuscript and approved the final version.
Supported by the Beijing Science and Technology Program, No. D171100002617004.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xi-Shan Wang, MD, Professor, Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China. wangxsh@126.com
Received: April 5, 2020
Peer-review started: April 5, 2020
First decision: April 22, 2020
Revised: April 27, 2020
Accepted: May 19, 2020
Article in press: May 19, 2020
Published online: June 6, 2020
ARTICLE HIGHLIGHTS
Research background
Claudin 7 has been found to be abnormally expressed in cancers and plays a critical role in the progression of some malignancies. However, there have been no studies on the clinical significance of claudin 7 in stage II colorectal cancer (CRC) to date. Therefore, it is necessary to clarify the potential value of claudin 7 in stage II CRC.
Research motivation
We evaluated the expression and prognostic value of claudin 7 in stage II CRC, and further constructed a prognostic grading system to accurately classify the survival difference among patients.
Research objectives
To assess the clinical significance of claudin 7 and construct a prognostic grading system for stage II CRC.
Research methods
This retrospective study included 231 stage II CRC patients who underwent radical surgery at our hospital from 2013 to 2014. The protein expression level of claudin 7 was assessed and its relationship with clinicopathological features and prognosis was statistically analyzed. The Kaplan-Meier method was used to assess the disease-free survival, and Cox proportional hazards models were used to determine the independent prognostic factors. A prognostic grading system was constructed to stratify the patients into different subgroups, and the survival differences among different subgroups were compared.
Research results
The expression of claudin 7 was decreased in cancer tissues compared to that in normal tissues, and its low expression was related to disease recurrence. Prognostic analysis showed that claudin 7 low expression (claudin 7-low) and perineural invasion positivity (PNI+) were independent prognostic factors associated with disease-free survival. A prognostic grading system based on the above two independent prognostic factors divided the patients into three prognostic grades: grade A (claudin 7-high and PNI-), grade B (claudin 7-low and PNI-, claudin 7-high and PNI+), and grade C (claudin 7-low and PNI+). Subgroup analysis showed that the prognosis of patients with different grades differed significantly.
Research conclusions
Our study identifies the prognostic significance of claudin 7 in stage II CRC. Furthermore, we also confirm that the prognostic grading system can better classify patient survival.
Research perspectives
The prognostic grading system can be used as an effective prognostic predictive tool to help clinicians more accurately predict survival.
