title: Ezrin expression is an independent prognostic factor in gastro-intestinal cancers.
abstract: BACKGROUND
  Ezrin, a member of the ezrin-radixin-moesin (ERM) family of plasma membrane-cytoskeleton linker proteins, has been associated with metastatic behavior.
  
  
  METHODS
  Microarrayed pathological tissues of surgically resected colorectal cancer liver metastasis (CRLM) and whole tissue sections of cancer of the ampulla of Vater (CAV) were analyzed to determine ezrin expression levels and correlation with survival. The requirement of ezrin in invasive capability was assessed using in vitro assays.
  
  
  RESULTS
  Surgically resected CAV showing a low ezrin score have a better 5-year disease-specific survival than those showing a high ezrin score (P < 0.0001). Similarly, high ezrin expression at the invasive front of CRLM resulted in poor disease-free survival (P = 0.05). Multivariate analysis demonstrated high ezrin expression to be an independent adverse prognostic factor for CAV (hazard ratio (HR) 15.22 (95 % confidence interval (CI) 1.98-117.03), P < 0.01) and CRLM (HR 6.42 (95 % CI 1.01-52.43), P = 0.05), among other clinically relevant variables such as lymph node metastasis (for CAV) and the presence of extrahepatic disease, large hepatic metastases (>5 cm), and close surgical resection margins (<5 mm) (all for CRLM). In vitro experiments indicated that ezrin expression was vital for cellular processes such as adhesive and invasive activity.
  
  
  CONCLUSIONS
  High ezrin expression indicates an adverse prognosis in primary CAV and CRLM.
authors.affiliation: Centre for Tumour Biology, John Vane Science Centre, Barts Cancer Institute-a CR-UK Centre of Excellence, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK.
authors.forename: Prabhu
authors.initials: P
authors.lastname: Arumugam
authors.forename: Stefano
authors.initials: S
authors.lastname: Partelli
authors.forename: Stacey J
authors.initials: SJ
authors.lastname: Coleman
authors.forename: Ivana
authors.initials: I
authors.lastname: Cataldo
authors.forename: Stefania
authors.initials: S
authors.lastname: Beghelli
authors.forename: Claudio
authors.initials: C
authors.lastname: Bassi
authors.forename: Nilukushi
authors.initials: N
authors.lastname: Wijesuriya
authors.forename: Jo-Anne Chin
authors.initials: JA
authors.lastname: Aleong
authors.forename: Fieke E M
authors.initials: FE
authors.lastname: Froeling
authors.forename: Aldo
authors.initials: A
authors.lastname: Scarpa
authors.forename: Hemant M
authors.initials: HM
authors.lastname: Kocher
mesh_terms: D014670:Ampulla of Vater; D015153:Blotting, Western; D003138:Common Bile Duct Neoplasms / Q000378:metabolism*; D003598:Cytoskeletal Proteins / Q000378:metabolism*; D018572:Disease-Free Survival; D005770:Gastrointestinal Neoplasms / Q000378:metabolism* / Q000401:mortality* / Q000473:pathology; D006801:Humans; D047468:Immunoprecipitation; D008113:Liver Neoplasms / Q000378:metabolism* / Q000556:secondary; D015999:Multivariate Analysis; D011379:Prognosis; D000099149:Ezrin
chemical_list: D003598:Cytoskeletal Proteins; D000099149:Ezrin