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Mismatch repair protein deficiency and its implications on distant metastasis in colorectal cancer: A comprehensive analysis

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机构: [1]Institute of Digestive Surgery, Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China [2]Department of Gastrointestinal, Bariatric and Metabolic Surgery, Research Center for Nutrition, Metabolism & Food Safety, West ChinaPUMC C.C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China [3]Department of Oncology and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden [4]Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China [5]Department of Medical Sciences, Örebro University, Örebro, Sweden
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关键词: colorectal cancer (CRC) IRF1 meta-analysis metastasis mismatch repair (MMR) weighted gene co-expression network analysis (WGCNA)

摘要:
While previous studies have indicated variability in distant metastatic potential among different mismatch repair (MMR) states in colorectal cancer (CRC), their findings remain inconclusive, especially considering potential differences across various ethnic backgrounds. Furthermore, the gene regulatory networks and the underlying mechanisms responsible for these variances in metastatic potential across MMR states have yet to be elucidated.We collected 2058 consecutive primary CRC samples from the South West of China and assessed the expression of MMR proteins (MLH1, MSH2, MSH6, and PMS2) using immunohistochemistry. To explore the inconsistencies between different MMR statuses and recurrence, we performed a meta-analysis. To delve deeper, we employed Weighted Gene Co-expression Network Analysis (WGCNA), ClueGo, and iRegulon, pinpointing gene expression networks and key regulatory molecules linked to metastasis and recurrence in CRC. Lastly, both univariate and multivariate Cox regression analyses were applied to determine the impact of core regulatory molecules on metastasis.Of the samples, 8.2% displayed deficient MMR (dMMR), with losses of MLH1 and PSM2 observed in 40.8% and 63.9%, respectively. A unique 24.3% isolated loss of PMS2 without concurrent metastasis was identified, a result that diverges from established literature. Additionally, our meta-analysis further solidifies the reduced recurrence likelihood in dMMR CRC samples compared to proficient MMR (pMMR). Two gene expression networks tied to distant metastasis and recurrence were identified, with a majority of metastasis-related genes located on chromosomes 8 and 18. An IRF1 positive feedback loop was discerned in the metastasis-related network, and IRF1 was identified as a predictive marker for both recurrence-free and distant metastasis-free survival across multiple datasets.Geographical and ethnic factors might influence peculiarities in MMR protein loss. Our findings also highlight new gene expression networks and crucial regulatory molecules in CRC metastasis, enhancing our comprehension of the mechanisms driving distant metastasis.© 2024 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

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大类 | 2 区 医学
小类 | 3 区 肿瘤学
第一作者:
第一作者机构: [1]Institute of Digestive Surgery, Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China [2]Department of Gastrointestinal, Bariatric and Metabolic Surgery, Research Center for Nutrition, Metabolism & Food Safety, West ChinaPUMC C.C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China [3]Department of Oncology and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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通讯机构: [1]Institute of Digestive Surgery, Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China [3]Department of Oncology and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden [4]Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China [*1]Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University,Chengdu, China [*2]Institute of Digestive Surgery, Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China [*3]Department of Oncology and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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