AIM: To assess the association belween the expression of Cry2 and the prognosis of coloreclal cancer for determining the role of Cry2 in predicting the outcome of chemotherapy. METHODS: Sixteen primary colorectal cancer patients who consecutively underwent neoadjuvant chemotherapy with 5 — fluorouracil were enrolled in the present study. The tumor specimens were obtained by colonscopy prior to treatment. The tumor response was evaluated by the response evaluation criteria in solid tumors (RECIST). Accordingly, the patients were divided into 2 groups; complete response (CR)/partial response (PR) and stable disease ( SD)/progress disease (PD). Two — tail % test was applied to analyze the data. In parallel, we assessed 307 patients, who underwent tumor resection between 2001 and 2005. Survival time was calculated from the date of surgery to the date of death or the last follow — up date. Survival curves were obtained by Kaplan — Meier method. Log — rank test was applied for univariate analysis. The Cox proportional hazards regression model was used to identify the independent prognostic factors. RESULTS: The expression of Cry2 was high in CR/PR patients and was low in SD/PD patients, with significant difference (P <0. 05). The average survival time of the 84 patients with high expression of Cry2 was 83. 458 months, while the average survival time of 223 patients with low expression of Cry2 was 100. 10 months, also with significant difference ( P < 0. 05 ) . The patients with low expression of Cry2 lived longer. The multivariate Cox regression analysis indicated that the expression of Cry2 was an independent prognostic factor for colorectal cancer patients ( HR was 1. 70, 95% CI was 1. 09 to 2. 66, P <0. 05) . Multivariate Cox regression showed that high Cry2 expression predicted a worse prognosis ( HR was 2. 88 , 95% CI was 1. 03 to 8. 06, P < 0. 05 ) in colorectal cane-er palienls with neoadjuvanl chemotherapy. CONCLUSION: Expression of Cry2 is an independent prognoslic faclor for coloreclal cancer palienls. Lower expression of Cry2 indicates good response Lo neoadjuvanl chemolherapy.%目的:检测Cry2在结直肠癌组织中的表达,探讨Cry2在结直肠癌预后和辅助化疗敏感性预测中的作用.方法:收集16名规律接受包含5-氟尿嘧啶的新辅助化疗的结直肠癌切除术患者,使用实体肿瘤疗效评估标准评估化疗疗效,并根据疗效分为完全反应(CR)/部分反应(PR)和 病灶稳定(SD)/病灶进展(PD)组,免疫组化检测Cry2表达,评分后进行双侧2检验.收集307名在2001年至2005年间接受结直肠癌切除术患者的肿瘤组织,制作组织芯片,免疫组化检测Cry2表达,用log-rank法进行单因素分析,用Cox回归模型进行多因素分析,用Kaplan-Meier法绘制生存曲线.结果:CR/PR组Cry2表达较低,SD/PD组Cry2表达较高,差异显著(P<0.05).307例中Cry2高表达者84人,平均生存83.46月,Cry2低表达者223人,平均生存100.10月,两组间差异显著(P<0.05).Cry2低表达者预后较好.307例结直肠癌切除术患者Cry2表达高低风险比为1.70,其95%置信区间为1.09～2.66,差异显著(P<0.05),Cry2的表达是影响预后的独立因素.16例接受化疗的结直肠癌切除术患者Cry2表达高低风险比为2.88,其95%置信区间为1.03～8.06,差异显著(P<0.05),Cry2的表达是影响化疗预后的独立因素.结论:根据Cry2表达高低可预测结直肠癌新辅助化疗的疗效,也可预测结直肠癌患者的预后.
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