title: High expression of phospho-H2AX predicts a poor prognosis in colorectal cancer.
abstract: OBJECTIVE
  Colorectal cancer (CRC) is one of the most common causes of cancer-related deaths worldwide. DNA double-strand breaks (DSBs) are deleterious lesions that can lead to chromosomal anomalies, genomic instability and cancer. The histone H2AX plays an important role in response to DNA damage and phosphorylation of H2AX (p-H2AX) is evidence of DSBs. The aim of this study was to evaluate the clinical significance of p-H2AX expression in CRC.
  
  
  METHODS
  p-H2AX expression in CRC tissues was analyzed by immunohistochemistry and correlated with clinicopathological variables using the chi-square test. The prognostic value of p-H2AX for distant metastasis-free survival (DMFS) and overall survival (OS) was evaluated by Kaplan-Meier estimates and the individual prognostic components were analyzed with Cox regression analysis.
  
  
  RESULTS
  A high p-H2AX expression in CRC tissues was associated with tumor stage and perineurial invasion. Furthermore, a high p-H2AX expression was associated with poor DMFS and OS. Cox regression analysis also revealed that p-H2AX was an independent predictor of DMFS and OS.
  
  
  CONCLUSIONS
  A high p-H2AX expression in CRC tissues is associated with a more malignant cancer behavior, as well as poor patient survival. p-H2AX may, therefore, be an independent prognostic predictor for CRC, as well as a potential therapeutic target.
authors: Translational Research Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C. Department of Respiratory Therapy, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C.
authors: Yi-Chen
authors: YC
authors: Lee
authors: Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C. Department of Surgery, Division of Gastrointestinal and General Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C. Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, R.O.C.
authors: Tzu Chieh
authors: TC
authors: Yin
authors: Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C. Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C.
authors: Yi-Ting
authors: YT
authors: Chen
authors: Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C. Department of Pathology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C.
authors: Chee-Yin
authors: CY
authors: Chai
authors: Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C. Department of Surgery, Division of Gastrointestinal and General Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C. Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, R.O.C.
authors: Jaw Yuan
authors: JY
authors: Wang
authors: Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C.
authors: Mei-Chi
authors: MC
authors: Liu
authors: Department of Anatomy, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C.
authors: Yuan-Chien
authors: YC
authors: Lin
authors: Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C. Department of Surgery, Division of Gastrointestinal and General Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C. Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, R.O.C. jykankmu@gmail.com.
authors: Jung Yu
authors: JY
authors: Kan
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000096:biosynthesis*; D015179:Colorectal Neoplasms / Q000235:genetics* / Q000473:pathology; D053903:DNA Breaks, Double-Stranded; D004249:DNA Damage / Q000235:genetics; D018572:Disease-Free Survival; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006657:Histones / Q000096:biosynthesis* / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010766:Phosphorylation; D011379:Prognosis
chemical_list: D014408:Biomarkers, Tumor; C468783:H2AX protein, human; D006657:Histones
keywords: colorectal cancer; immunohisto che mistry; phospho-H2AX; prognosis