43 - Freie Mitteilung
Colorectal I
16. Mai 2019, 08:30 - 10:00, Szenario 1, 5. OG


Fascin-1 expression in colorectal cancer: Is there a high risk group of patients prone to metastasis already in early stage disease?
A. Tampakis1, E. C. Tampaki2, A. Nonni2, K. Kontzoglou2, G. Tsourouflis2, E. Patsouris2, G. Kouraklis2, Presenter: A. Tampakis1 (1Basel, 2Athens/GR)

Fascin is a stem cell marker that regulates adhesion dynamics and stabilizes cell protrusion such as filopodia. In human cancer, fascin expression has been correlated with malignant tumors exhibiting aggressive clinical features. The aim of the present study was to assess the expression patterns of fascin in colorectal cancer and to determine its prognostic significance.
A validated assay comprised of 111 specimens of patients with primary resectable colorectal cancer, were assessed via immunohistochemistry for the expression of fascin-1. Cut-off points to define levels of expression of fascin-1 were determined by using Roc-curve and X-tile. Results were correlated with clinicopathological characteristics and survival data.
Fascin-1 was strongly expressed in the cytoplasm of the colorectal cancer cells and in endothelial cells of tumor blood vessels. High fascin-1 expression was associated with progressive T stage (p=0.007), the presence of lymph nodes (p<0.001) and distant metastasis (p=0.002), low grade differentiation (p=0.002), vascular invasion (p<0.001). Patients exhibiting high expression of fascin-1 demonstrated a significantly worse 3-year progression free survival (20% vs 75%, p<0.001) and 5-year overall survival (13.3% vs 80%, p<0.001). Subgroup analysis comprised of patients with UICC stage I and II only, demonstrated as well a significantly worse 5-year overall survival (48% vs 93.5%, p=0.007) when fascin-1 expression exists. High fascin-1 expression was confirmed in the multivariate analysis using Cox proportional hazard models as an independent prognostic factor of worse progression free survival (HR; 0.290, 95% CI=0.118-0.714) and poor overall survival (HR; 0.256, 95% CI=0.082-0.800).
High fascin-1 expression in colorectal cancer is an independent negative prognostic factor for progression free and overall survival. Fascin-1 could possibly represent a target for immunotherapy or could be utilized to identify patients at high risk to develop disease recurrence and/or metastasis already in early stage disease.
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