title: Overexpression of podocalyxin-like protein is an independent factor of poor prognosis in colorectal cancer.
abstract: BACKGROUND
  Podocalyxin-like 1 (PODXL) is a cell-adhesion glycoprotein and stem cell marker that has been associated with an aggressive tumour phenotype and poor prognosis in several forms of cancer. In this study, we investigated the prognostic impact of PODXL expression in colorectal cancer (CRC).
  
  
  METHODS
  Using tissue microarrays and immunohistochemistry, PODXL expression was evaluated in 536 incident CRC cases from a prospective, population-based cohort study. Kaplan-Meier analysis and Cox proportional hazards modelling were used to assess the impact of PODXL expression on cancer-specific survival (CSS) and overall survival (OS).
  
  
  RESULTS
  High PODXL expression was significantly associated with unfavourable clinicopathological characteristics, a shorter CSS (hazard ratio (HR)=1.98; 95% confidence interval (CI) 1.38-2.84, P<0.001) and 5-year OS (HR=1.85; 95% CI 1.29-2.64, P=0.001); the latter remaining significant in multivariate analysis (HR=1.52; 95% CI 1.03-2.25, P=0.036). In addition, in curatively resected stage III (T1-4, N1-2, M0) patients (n=122) with tumours with high PODXL expression, a significant benefit from adjuvant chemotherapy was demonstrated (p(interaction) =0.004 for CSS and 0.015 for 5-year OS in multivariate analysis).
  
  
  CONCLUSIONS
  Podocalyxin-like 1 expression is an independent factor of poor prognosis in CRC. Our results also suggest that PODXL may be a useful marker to stratify patients for adjuvant chemotherapy.
authors.affiliation: Department of Clinical Sciences, Division of Pathology, Lund University, Skåne University Hospital, 221 85, Lund, Sweden. anna_h.larsson@med.lu.se
authors.forename: A
authors.initials: A
authors.lastname: Larsson
authors.forename: M E
authors.initials: ME
authors.lastname: Johansson
authors.forename: S
authors.initials: S
authors.lastname: Wangefjord
authors.forename: A
authors.initials: A
authors.lastname: Gaber
authors.forename: B
authors.initials: B
authors.lastname: Nodin
authors.forename: P
authors.initials: P
authors.lastname: Kucharzewska
authors.forename: C
authors.initials: C
authors.lastname: Welinder
authors.forename: M
authors.initials: M
authors.lastname: Belting
authors.forename: J
authors.initials: J
authors.lastname: Eberhard
authors.forename: A
authors.initials: A
authors.lastname: Johnsson
authors.forename: M
authors.initials: M
authors.lastname: Uhlén
authors.forename: K
authors.initials: K
authors.lastname: Jirström
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism / Q000502:physiology; D002277:Carcinoma / Q000175:diagnosis* / Q000378:metabolism / Q000401:mortality; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012795:Sialoglycoproteins / Q000378:metabolism* / Q000502:physiology; D016019:Survival Analysis; D015854:Up-Regulation
chemical_list: D014408:Biomarkers, Tumor; D012795:Sialoglycoproteins; C001643:podocalyxin