PLA2G2A overexpression is associated with poor therapeutic response and inferior outcome in rectal cancer patients receiving neoadjuvant concurrent chemoradiotherapy. Issue 7 (13th January 2015)

• Record Type: Journal Article
• Authors: He, Hong‐Lin; Lee, Ying‐En; Shiue, Yow‐Ling; Lee, Sung‐Wei; Lin, Li‐Ching; Chen, Tzu‐Ju; Wu, Ting‐Feng; Li, Chien‐Feng
• Is Part Of: Histopathology. Volume 66:Issue 7(2015)
• Page Start: 991
• Page End: 1002
• Publication Date: 2015-01-13
• Subjects: CCRT -- chemoradiotherapy -- PLA2G2A -- rectal cancer; Histology, Pathological -- Periodicals; 611.018
• DOI: 10.1111/his.12613
• Languages: English
• ISSNs: 0309-0167

Abstract

Abstract : Aims: The aim of this study was to investigate the prognostic impact of group IIA phospholipase A2 (PLA2G2A) expression and its role in predicting the response to neoadjuvant concurrent cheomoradiotherapy (CCRT) in rectal cancer. Methods and results: Through analysing a public transcriptome of rectal cancers, the PLA2G2A gene was identified as a significant predictor for CCRT response. We validated the expression of PLA2G2A using immunohistochemistry in the pretreatment tumour specimens from 172 patients with rectal cancer. The results were correlated with clinicopathological features, tumour regression grade, overall survival (OS), disease‐free survival (DFS) and local recurrence‐free survival (LRFS). High expression of PLA2G2A was associated with advanced pretreatment tumour status ( P = 0.001), advanced pretreatment nodal status ( P = 0.010), advanced post‐treatment tumour status ( P = 0.002) and lower tumour regression grade ( P = 0.006). Furthermore, PLA2G2A expression was correlated negatively with gamma H2A histone family, member X (γ‐H2AX) expression ( P < 0.001, r = −0.580). More importantly, high expression of PLA2G2A emerged as an adverse prognostic factor for OS ( P = 0.0190), DFS ( P < 0.0001) and LRFS ( P < 0.0001). In multivariate analysis, it remained independently prognostic for shorter DFS ( P = 0.014) and LRFS ( P = 0.012). Conclusions: High expression of PLA2G2A was associated with poor therapeutic response and worse survival in patients with rectal cancer receiving neoadjuvant CCRT, justifying PLA2G2A as an important marker to predict CCRT response and outcome.