title: Role of autophagy-related protein expression in patients with rectal cancer treated with neoadjuvant chemoradiotherapy.
abstract: BACKGROUND
  Autophagy, a cellular degradation process, has complex roles in tumourigenesis and resistance to cancer treatment in humans. The aim of this study was to explore the expression levels of autophagy-related proteins in patients with rectal cancer and evaluate their clinical role in the neoadjuvant chemoradiotherapy setting.
  
  
  METHODS
  All specimens evaluated were obtained from 101 patients with colorectal cancer who had undergone neoadjuvant chemoradiotherapy and curative surgery. The primary outcomes measured were the expression levels of two autophagy-related proteins (microtubule-associated protein 1 light chain 3 beta (LC3β) and beclin-1) by immunohistochemistry and their association with clinicopathological parameters and patient survival.
  
  
  RESULTS
  Among the 101 patients, the frequency of high expression of beclin-1 was 31.7% (32/101) and that of LC3β was 46.5% (47/101). A pathologic complete response was inversely associated with LC3β expression (P = 0.003) and alterations in the expression of autophagy-related proteins (P = 0.046). In the multivariate analysis, however, autophagy-related protein expression did not show prognostic significance for relapse-free survival or overall survival.
  
  
  CONCLUSIONS
  High expression of autophagy-related proteins shows a strong negative association with the efficacy of neoadjuvant chemoradiotherapy in patients with rectal cancer. Autophagy has clear implications as a therapeutic target with which to improve the efficacy of neoadjuvant chemoradiotherapy.
authors.affiliation: Division of Oncology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Byoung Yong
authors.initials: BY
authors.lastname: Shim
authors.affiliation: Division of Oncology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Der Sheng
authors.initials: S
authors.lastname: Sun
authors.affiliation: Division of Oncology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Hye Sung
authors.initials: HS
authors.lastname: Won
authors.affiliation: Division of Oncology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.|Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Myung Ah
authors.initials: MA
authors.lastname: Lee
authors.affiliation: Department of Pathology, College of Medicine, Chung-Ang University, Seoul, Republic of Korea.
authors.forename: Soon Uk
authors.initials: SU
authors.lastname: Hong
authors.affiliation: Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Ji-Han
authors.initials: JH
authors.lastname: Jung
authors.affiliation: Department of General Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Hyeon-Min
authors.initials: HM
authors.lastname: Cho
authors.affiliation: Division of Oncology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. koyoonho@catholic.ac.kr.|Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. koyoonho@catholic.ac.kr.
authors.forename: Yoon Ho
authors.initials: YH
authors.lastname: Ko
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001343:Autophagy / Q000187:drug effects / Q000235:genetics / Q000528:radiation effects; D000071183:Autophagy-Related Proteins / Q000096:biosynthesis / Q000235:genetics; D000071186:Beclin-1 / Q000096:biosynthesis* / Q000235:genetics; D014408:Biomarkers, Tumor / Q000096:biosynthesis / Q000235:genetics; D059248:Chemoradiotherapy; D018572:Disease-Free Survival; D005260:Female; D015972:Gene Expression Regulation, Neoplastic / Q000187:drug effects / Q000528:radiation effects; D006801:Humans; D008297:Male; D008869:Microtubule-Associated Proteins / Q000096:biosynthesis* / Q000235:genetics; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology / Q000532:radiotherapy*; D011379:Prognosis; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology / Q000532:radiotherapy*
chemical_list: D000071183:Autophagy-Related Proteins; D000071186:Beclin-1; D014408:Biomarkers, Tumor; C502070:MAP1LC3B protein, human; D008869:Microtubule-Associated Proteins
keywords: Autophagy; Beclin-1; LC3β; Neoadjuvant chemoradiotherapy; Prognosis; Rectal cancer