Evaluation of CXCL12 and CXCR4 to predict poor survival in lymph node-positive colorectal cancer patients

Abstract

It is well known that interactions in the tumour microenvironment are very important in the progression of tumours. We investigated the relationship between chemokine ligand type 12 (CXCL12), chemokine receptor type 4 (CXCR4) and survival in advanced colorectal cancers (CRC). Primary tumour samples of stage III-IV CRC patients were investigated for CXCL12 and CXCR4. Chemokine ligand type 12 and CXCR4 expressions were significantly associated with poor prognostic factors (e.g. for CXCL12: lymphatic invasion [p = 0.009], positive surgical margin [p = 0.006], advanced stage [p = 0.028], etc.). Also, these parameters were independent risk factors for low LIR (e.g. for CXCL12: Odds ratio [OR] = 2.27, p = 0.001) and low tumour stroma-ratio (TSR; e.g. for CXCL12: OR = 1.18, p = 0.003). In univariate analysis, 5-year RFS and OS were poor (e.g. for CXCL12: RFS, p < 0.001 and OS, p = 0.001). Multivariate analysis showed that these parameters were independent poor survival parameters for RFS and OS (e.g. for CXCL12: Hazard ratio [HR] = 3.54 [CI: 1.52-4.67], p = 0.001 and HR = 2.74 [1.48-4.71], p = 0.025). We showed that CXCL12 and CXCR4 expressions are poor prognostic factors in lymph node-positive CRC patients and are associated with low TSR and low LIR.