title: SOX2 expression correlates with lymph-node metastases and distant spread in right-sided colon cancer.
abstract: BACKGROUND
  The transcription factor SOX2, which is involved in the induction of pluripotent stem cells and contributes to colorectal carcinogenesis, is associated with a poor prognosis in colon cancer (CC). Furthermore, SOX2 is a repressor of the transcriptional activity of β-catenin in vitro. Since the majority of CC develop via an activation of the Wnt/β-catenin signalling pathway, indicated by nuclear expression of β-catenin, we wanted to investigate the expression patterns of SOX2 and β-catenin and correlate them with the occurrence of lymph node and distant metastases as indicators of malignant progression.
  
  
  METHODS
  The expression of SOX2 and β-catenin was investigated in a case control study utilizing a matched pair collection (N = 114) of right-sided CCs with either corresponding distant metastases (N = 57) or without distant spread (N = 57) by applying immunohistochemistry.
  
  
  RESULTS
  Elevated protein expression of SOX2 significantly correlated with the presence of lymph node- (p = 0.006) and distant metastases (p = 0.022). Nuclear β-catenin expression correlated significantly only with distant metastases (p = 0.001). Less than 10% of cases showed a coexpression of high levels of β-catenin and SOX2. The positivity for both markers was also associated with a very high risk for lymph-node metastases (p = 0.007) and distant spread (p = 0.028).
  
  
  CONCLUSIONS
  We demonstrated that increased expression of either SOX2 or nuclear β-catenin are associated with distant metastases in right-sided CC. Additionally, SOX2 is also associated with lymph-node metastases. These data underline the importance of stemness-associated markers for the identification of CC with high risk for distant spread.
authors.affiliation: Pathologisches Institut, Ludwig-Maximilians-Universität München, Munich, Germany. jens.neumann@med.uni-muenchen.de
authors.forename: Jens
authors.initials: J
authors.lastname: Neumann
authors.forename: Fiorina
authors.initials: F
authors.lastname: Bahr
authors.forename: David
authors.initials: D
authors.lastname: Horst
authors.forename: Lydia
authors.initials: L
authors.lastname: Kriegl
authors.forename: Jutta
authors.initials: J
authors.lastname: Engel
authors.forename: Raquel Mejias
authors.initials: RM
authors.lastname: Luque
authors.forename: Markus
authors.initials: M
authors.lastname: Gerhard
authors.forename: Thomas
authors.initials: T
authors.lastname: Kirchner
authors.forename: Andreas
authors.initials: A
authors.lastname: Jung
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism* / Q000556:secondary; D000368:Aged; D016022:Case-Control Studies; D003110:Colonic Neoplasms / Q000378:metabolism* / Q000556:secondary; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000378:metabolism*; D055748:SOXB1 Transcription Factors / Q000378:metabolism*; D051176:beta Catenin / Q000378:metabolism
chemical_list: D009363:Neoplasm Proteins; C527782:SOX2 protein, human; D055748:SOXB1 Transcription Factors; D051176:beta Catenin