Low HES-1 and positive DLL4 expression predicts poor prognosis of colorectal cancers
- Authors
- Kim, Gilhyang; Jung, Jiyoon; Kim, Jeong Won; Kim, Joo Young
- Issue Date
- Feb-2023
- Publisher
- ELSEVIER
- Keywords
- Colorectal cancers; HES-1; DLL4; prognosis
- Citation
- PATHOLOGY, v.55, no.1, pp 52 - 57
- Pages
- 6
- Journal Title
- PATHOLOGY
- Volume
- 55
- Number
- 1
- Start Page
- 52
- End Page
- 57
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/71178
- DOI
- 10.1016/j.pathol.2022.07.008
- ISSN
- 0031-3025
1465-3931
- Abstract
- Hairy and enhancer of split-1 (HES-1) is a downstream transcription factor and delta-like 4 (DLL4) is a ligand of the Notch signalling pathway. HES-1 and DLL4 expression are known to have an association with the progression and metastasis of cancers. We evaluated HES-1 and DLL4 expression and assessed their correlation with biological behaviour and prognostic significance of 327 colorectal cancers. Low HES-1 expression was identified in 210 (64.2%) cases and was significantly correlated with large tumour size, lymphovascular invasion, and distant metas-tasis. DLL4 was positive in 132 (40.4%) cases and significantly correlated with perineural invasion, distant metastasis, and involved resection margin. Patients with low HES-1 expression showed significantly worse overall survival than patients with high HES-1 expression [hazard ratio (HR)=3.017; 95% confidence interval (CI) 1.880-4.841; p<0.001]. The overall survival of patients with positive DLL4 expression was significantly worse than that of patients with negative DLL4 expression (HR=2.922; 95% CI 1.976-4.322; p<0.001). Furthermore, the com-bined HES-1lowDLL4positive expression group showed the worst overall survival compared to other groups (p<0.001) and was an independent poor prognostic factor of colo-rectal cancer patients. Thus, low HES-1 and positive DLL4 expression are associated with aggressive biological behaviour and can be used as prognostic factors in colo-rectal cancer patients.
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