title: Increased expression of tumor necrosis factor-α is associated with advanced colorectal cancer stages.
abstract: OBJECTIVE
  To detect the expression of tumor necrosis factor-α (TNF-α) in colorectal cancer (CRC) cells among Saudi patients, and correlate its expression with clinical stages of cancer.
  
  
  METHODS
  Archival tissue specimens were collected from 30 patients with CRC who had undergone surgical intervention at King Khalid University Hospital. Patient demographic information, including age and gender, tumor sites, and histological type of CRC, was recorded. To measure TNF-α mRNA expression in CRC, total RNA was extracted from tumor formalin-fixed, paraffin-embedded, and adjacent normal tissues. Reverse transcription and reverse transcription polymerase chain reaction were performed. Colorectal tissue microarrays were constructed to investigate the protein expression of TNF-α by immunohistochemistry.
  
  
  RESULTS
  The relative expression of TNF-α mRNA in colorectal cancer was significantly higher than that seen in adjacent normal colorectal tissue. High TNF-α gene expression was associated with Stage III and IV neoplasms when compared with earlier tumor stages (P = 0.004). Eighty-three percent of patients (25/30) showed strong TNF-α positive staining, while only 10% (n = 3/30) of patients showed weak staining, and 7% (n = 2/30) were negative. We showed the presence of elevated TNF-α gene expression in cancer cells, which strongly correlated with advanced stages of tumor.
  
  
  CONCLUSIONS
  High levels of TNF-α expression could be an independent diagnostic indicator of colorectal cancer, and targeting TNF-α might be a promising prognostic tool by assessment of the clinical stages of CRC.
authors.affiliation: Omar A Al Obeed, Khayal A Alkhayal, Ahmad M Zubaidi, Mansoor-Ali Vaali-Mohammed, Maha-Hamadien Abdulla, Colorectal Research Center, Department of Surgery, King Saud University, Riyadh 11472, Saudi Arabia.
authors.forename: Omar A
authors.initials: OA
authors.lastname: Al Obeed
authors.affiliation: Omar A Al Obeed, Khayal A Alkhayal, Ahmad M Zubaidi, Mansoor-Ali Vaali-Mohammed, Maha-Hamadien Abdulla, Colorectal Research Center, Department of Surgery, King Saud University, Riyadh 11472, Saudi Arabia.
authors.forename: Khayal A
authors.initials: KA
authors.lastname: Alkhayal
authors.affiliation: Omar A Al Obeed, Khayal A Alkhayal, Ahmad M Zubaidi, Mansoor-Ali Vaali-Mohammed, Maha-Hamadien Abdulla, Colorectal Research Center, Department of Surgery, King Saud University, Riyadh 11472, Saudi Arabia.
authors.forename: Abdulmalik
authors.initials: A
authors.lastname: Al Sheikh
authors.affiliation: Omar A Al Obeed, Khayal A Alkhayal, Ahmad M Zubaidi, Mansoor-Ali Vaali-Mohammed, Maha-Hamadien Abdulla, Colorectal Research Center, Department of Surgery, King Saud University, Riyadh 11472, Saudi Arabia.
authors.forename: Ahmad M
authors.initials: AM
authors.lastname: Zubaidi
authors.affiliation: Omar A Al Obeed, Khayal A Alkhayal, Ahmad M Zubaidi, Mansoor-Ali Vaali-Mohammed, Maha-Hamadien Abdulla, Colorectal Research Center, Department of Surgery, King Saud University, Riyadh 11472, Saudi Arabia.
authors.forename: Mansoor-Ali
authors.initials: MA
authors.lastname: Vaali-Mohammed
authors.affiliation: Omar A Al Obeed, Khayal A Alkhayal, Ahmad M Zubaidi, Mansoor-Ali Vaali-Mohammed, Maha-Hamadien Abdulla, Colorectal Research Center, Department of Surgery, King Saud University, Riyadh 11472, Saudi Arabia.
authors.forename: Robin
authors.initials: R
authors.lastname: Boushey
authors.affiliation: Omar A Al Obeed, Khayal A Alkhayal, Ahmad M Zubaidi, Mansoor-Ali Vaali-Mohammed, Maha-Hamadien Abdulla, Colorectal Research Center, Department of Surgery, King Saud University, Riyadh 11472, Saudi Arabia.
authors.forename: James H
authors.initials: JH
authors.lastname: Mckerrow
authors.affiliation: Omar A Al Obeed, Khayal A Alkhayal, Ahmad M Zubaidi, Mansoor-Ali Vaali-Mohammed, Maha-Hamadien Abdulla, Colorectal Research Center, Department of Surgery, King Saud University, Riyadh 11472, Saudi Arabia.
authors.forename: Maha-Hamadien
authors.initials: MH
authors.lastname: Abdulla
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis* / Q000235:genetics; D015179:Colorectal Neoplasms / Q000737:chemistry* / Q000235:genetics / Q000473:pathology; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012333:RNA, Messenger / Q000032:analysis; D060888:Real-Time Polymerase Chain Reaction; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012529:Saudi Arabia; D046888:Tissue Array Analysis; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis* / Q000235:genetics; D015854:Up-Regulation
chemical_list: D014408:Biomarkers, Tumor; D012333:RNA, Messenger; D014409:Tumor Necrosis Factor-alpha
keywords: Colorectal cancer; Immunohistochemistry; Real time polymerase chain reaction; Tumor necrosis factor-α; mRNA