title: Prognostic value of biomarkers in metastatic colorectal cancer patients.
abstract: BACKGROUND
  The prognostic value of biomarkers in metastatic colorectal cancer (mCRC) patients with liver metastases remains unclear. We assessed the difference of expression of biomarkers between primary tumors and liver metastases treated with chemotherapy in mCRC patients, as well as the prognostic value of these markers.
  
  
  METHODS
  Forty-three mCRC patients with liver-limited disease from January 2007-November 2011 were analyzed. They all received resection of primary tumors followed by oxaliplatin-based chemotherapy. After chemotherapy, they all received hepatic resection. Forty-three paired primary and metastatic tumor specimens were collected to measure the messenger RNA expression of six biomarkers by the Danenberg tumor profile method (thymidylate synthase, dihydropyrimidine dehydrogenase [DPD], excision repair cross-complementing gene1, thymidine phosphorylase [TP], folylpolyglutamate synthase, and regenerating islet-derived family, member 4).
  
  
  RESULTS
  Thirty-six patients' messenger RNA was used for analysis. All markers showed similar expression between primary and metastatic sites. The low-expression group of Danenberg tumor profile and TP in the primary tumor showed significantly higher overall survival than the high-expression group (P < 0.001 and P = 0.033), but for DPD and TP in liver metastases, there were no significant differences of overall survival between the two groups. The ratios of marker expression in liver metastatic site to that in primary site of DPD and TP were significantly higher in chemo-responders than in non-chemo-responders (P = 0.034 and P = 0.022).
  
  
  CONCLUSIONS
  Biomarkers' expressions in liver metastases were similar to those in the primary tumor. DPD and TP in the primary lesion may be a prognostic factor in chemotherapy-naïve mCRC patients with liver-limited disease, but those in liver tumor were not. Further validated analysis to our results would be warranted.
authors.affiliation: Department of Surgery, Osaka Red-Cross Hospital, Osaka, Japan. Electronic address: kozokataoka@hotmail.co.jp.
authors.forename: Kozo
authors.initials: K
authors.lastname: Kataoka
authors.affiliation: Department of Gastroenterological Surgery and Oncology, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan.
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Kanazawa
authors.affiliation: Department of Surgery, Osaka Red-Cross Hospital, Osaka, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Nakajima
authors.affiliation: Department of Surgery, Osaka Red-Cross Hospital, Osaka, Japan.
authors.forename: Ayane
authors.initials: A
authors.lastname: Yamaguchi
authors.affiliation: Department of Surgery, Osaka Red-Cross Hospital, Osaka, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Arimoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000378:metabolism*; D015179:Colorectal Neoplasms / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology / Q000601:surgery; D008113:Liver Neoplasms / Q000378:metabolism* / Q000556:secondary* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor
keywords: Colorectal cancer; DPD; Liver metastases; Prognostic marker; TP