Oncotarget: Mesothelin expression in preoperative colorectal cancer prognosis

Oncotarget published "Significance of mesothelin expression in preoperative endoscopic biopsy specimens for colorectal cancer prognosis" which reported that mesothelin is a cell surface glycoprotein that is normally expressed in the mesothelial cells but highly expressed in several malignant tumors, where the high expression is generally associated with poor prognosis.

In this work, 512 patients with stage III colorectal cancer were examined to ascertain the prognostic value of Mesothelin expression (MSLN) expression in preoperative endoscopic biopsy specimens.

Besides, by multivariate analysis, MSLN expression was identified to be a marker of poor prognosis by multivariate analysis as well as macroscopic type among the factors that can be evaluated preoperatively.

This Oncotarget article concluded that high MSLN expression observed in preoperative endoscopic biopsy specimens of stage III CRC was an independent poor prognostic factor.

This Oncotarget article concluded that high MSLN expression observed in preoperative endoscopic biopsy specimens of stage III CRC was an independent poor prognostic factor.

Preoperative evaluation of MSLN by immunohistochemical staining might be applied to select individuals for intensive preoperative chemotherapy among the stage III CRC patients.

Dr. Eiji Shinto from The Department of Surgery at The National Defense Medical College said, "Colorectal cancer (CRC) is one of the most common cancers worldwide and is the second most frequent cause of cancer-related mortality in Japan."

MSLN is highly expressed in several malignant tumors, and its expression, which is reportedly related to the Wnt signaling pathway, might be associated with patient prognosis.

For stage II/III CRC, we previously demonstrated that MSLN expression is a robust independent prognostic factor using standard sections, which were the maximum sections that included the invasive margin of the cancer.

Figure 6: Postrecurrent disease-specific survival rate. Compares the survival probabilities after recurrence between the MSLN-positive and negative patients. After recurrence, MSLN-positive patients tended to have a poorer survival; that is, the 3-year survival rates were 22.6% in the MSLN-positive group and 47.4% in the MSLN-negative group (P = 0.073).

In addition, the authors evaluated the expression of MSLN in four specific areas by immunohistochemical staining and found that MSLN expression exhibits little heterogeneity and correlates with poorer prognosis regardless of the area.

Their previous observations revealed that approximately 50% of patients with stage III CRC who show high MSLN expression develop postoperative recurrence.

Furthermore, the homogeneity of MSLN expression was reconfirmed by comparing the expression in the biopsy tissue with that in the invasive frontal margin of the cancer.

The Shinto Research Team concluded in their Oncotarget Research Output, "in the present study, high MSLN expression observed in preoperative endoscopic biopsy specimens of stage III CRC was an independent poor prognostic factor. Preoperative evaluation of MSLN by immunohistochemical staining might be useful in predicting the recurrence risk. Further investigations are necessary to understand the usefulness of MSLN in selecting stage III CRC patients for NAC."

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DOI - https://doi.org/10.18632/oncotarget.27774

Full text - https://www.oncotarget.com/article/27774/text/

Correspondence to - Eiji Shinto - shinto@ndmc.ac.jp

Keywords - colorectal cancer, mesothelin, endoscopic biopsy specimen, immunohistochemistry, Pathology

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