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GUCY2C in lymph nodes associated with DFS, time to recurrence in pN0 colorectal cancer
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In results published online Tuesday, researchers working in Philadelphia and Quebec have determined that expression of the gene GUCY2C in the lymph nodes of patients with pN0 colorectal cancer is independently associated with inferior DFS and time to recurrence.
The researchers evaluated the lymph nodes of 257 patients using quantitative reverse transcriptase–polymerase chain reaction and detected GUCY2C in 225 patients, which they said indicated the presence of occult metastases. After a median follow-up of 24 months for patients with pN0 (mol+) disease (n=225) and 35.9 months for patients with pN0 (mol–) disease (n=32), the researchers found that 20.9% (95% CI, 15.8%-26.8%) of those with occult metastases developed recurrent disease. In contrast, only 6.3% of patients without occult metastases had recurrence (95% CI, 0.8%-20.8%).
The researchers added that two patients who had recurrence despite testing negative for GUCY2C provided two or less lymph nodes for analysis. They suggested that there were not enough samples from those patients for adequate testing.
Only the presence of GUCY2C served as a prognostic factor for DFS and time to recurrence, according to the researchers. Patients with pN0 (mol+) disease had shorter time to recurrence compared with those who had pN0 (mol–) disease (HR=4.66; 95% CI, 1.11-19.57). Patients with pN0 (mol+) disease also had poorer rates of DFS compared with those who had pN0 (mol–) disease (HR=3.27; 95% CI, 1.15-9.29).
JAMA. 2009;301:745-752.