J Pathol Transl Med.  2018 Jan;52(1):37-44. 10.4132/jptm.2017.10.20.

The Smad4/PTEN Expression Pattern Predicts Clinical Outcomes in Colorectal Adenocarcinoma

• Chung Y
• Wi YC
• Kim Y
• Bang SS
• Yang JH
• Jang K
• Min KW
• Paik SS

• KMID: 2403256
• DOI: http://doi.org/10.4132/jptm.2017.10.20

Abstract

BACKGROUND
Smad4 and PTEN are prognostic indicators for various tumor types. Smad4 regulates tumor suppression, whereas PTEN inhibits cell proliferation. We analyzed and compared the performance of Smad4 and PTEN for predicting the prognosis of patients with colorectal adenocarcinoma.
METHODS
Combined expression patterns based on Smad4+/- and PTEN+/- status were evaluated by immunostaining using a tissue microarray of colorectal adenocarcinoma. The relationships between the protein expression and clinicopathological variables were analyzed.
RESULTS
Smad4-/PTEN- status was most frequently observed in metastatic adenocarcinoma, followed by primary adenocarcinoma and tubular adenoma (p<.001). When Smad4-/PTEN- and Smad4+/PTEN+ groups were compared, Smad4-/PTEN- status was associated with high N stage (p=.018) and defective mismatch repair proteins (p=.006). Significant differences in diseasefree survival and overall survival were observed among the three groups (Smad4+/PTEN+, Smad4-/PTEN+ or Smad4+/PTEN-, and Smad4-/PTEN-) (all p<.05).
CONCLUSIONS
Concurrent loss of Smad4 and PTEN may lead to more aggressive disease and poor prognosis in patients with colorectal adenocarcinoma compared to the loss of Smad4 or PTEN alone.

Keyword

Smad4; PTEN; Prognosis; Colon neoplasms; Humans

MeSH Terms

Adenocarcinoma*
Adenoma
Cell Proliferation
Colonic Neoplasms
DNA Mismatch Repair
Humans
Prognosis

Figure

• 

  Fig. 1. Microphotographs showing immunohistochemical staining of Smad4 (A) and PTEN (B) expression in colorectal adenocarcinoma tissue.

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  Fig. 2. Proportions of different tissues showing Smad4–/PTEN–staining: normal (0%), adenoma (7.2%), primary adenocarcinoma (31.2%), and metastatic adenocarcinoma (35.4%).

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  Fig. 3. Disease-free survival (A) and overall survival (B) curves derived by the Kaplan–Meier method showing the correlation of survival with Smad4/PTEN expression status.

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