title: Down-regulation of Barx2 predicts poor survival in colorectal cancer.
abstract: Human BarH-like homeobox 2 (Barx2), a homeodomain factor of the Bar family, has an important role in controlling the expression of cell adhesion molecules and has been reported in an increasing array of tumor types except colorectal cancer (CRC). The purpose of the current study was to characterize the expression of Barx2 and assess the clinical significance of Barx2 in CRC. First, we analyzed the expression of Barx2 in two independent public datasets from Oncomine. Subsequently, we evaluated Barx2 mRNA and protein expression by quantitative real-time PCR and western blotting, respectively. It was determined that Barx2 expression was lower in tumor tissues than in adjacent non-tumorous colorectal tissues of CRC patients, consistent with results from the public datasets. Subsequently, a tissue microarray containing 196 CRC specimens was evaluated for Barx2 expression by immunohistochemical staining. It was found that low expression of Barx2 significantly correlated with TNM stage, AJCC stage, differentiation, and relapse in patients with CRC. Patients with lower levels of Barx2 expression showed reduced disease-free survival and overall survival. Furthermore, a trend toward shorter overall survival in the patient group with Barx2-negative tumors independent of advanced AJCC stage and poor differentiation was determined by Kaplan-Meier survival analysis. Based on univariate and multivariate analyses, Barx2 expression was an independent prognostic factor for determining CRC prognosis. Taken together, low Barx2 expression was associated with the progression of CRC and could serve as a potential independent prognostic biomarker for patients with CRC.
authors.affiliation: Department of General Surgery, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University, 85 Wujin Road, 200080 Shanghai, China. Electronic address: miyushuai@sina.com.
authors.forename: Yushuai
authors.initials: Y
authors.lastname: Mi
authors.affiliation: Department of General Surgery, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University, 85 Wujin Road, 200080 Shanghai, China; Department of Oncology and Department of Clinical and Experimental Medicine, Linkoping University, SE-581 85 Linkoping, Sweden. Electronic address: sunshinezsl1989@163.com.
authors.forename: Senlin
authors.initials: S
authors.lastname: Zhao
authors.affiliation: Department of General Surgery, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University, 85 Wujin Road, 200080 Shanghai, China. Electronic address: zhangweihao@163.com.
authors.forename: Weihao
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University, 85 Wujin Road, 200080 Shanghai, China. Electronic address: zhangdongyuan@163.com.
authors.forename: Dongyuan
authors.initials: D
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University, 85 Wujin Road, 200080 Shanghai, China. Electronic address: JEROME6694@163.com.
authors.forename: Junyong
authors.initials: J
authors.lastname: Weng
authors.affiliation: Department of General Surgery, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University, 85 Wujin Road, 200080 Shanghai, China. Electronic address: huangkejian@163.com.
authors.forename: Kejian
authors.initials: K
authors.lastname: Huang
authors.affiliation: Department of Pathology, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University, 85 Wujin Road, 200080 Shanghai, China. Electronic address: 122400746@qq.com.
authors.forename: Huimin
authors.initials: H
authors.lastname: Sun
authors.affiliation: Department of Pathology, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University, 85 Wujin Road, 200080 Shanghai, China. Electronic address: tanghuamei@gmail.com.
authors.forename: Huamei
authors.initials: H
authors.lastname: Tang
authors.affiliation: Department of Pathology, Zhejiang Provincial People's Hospital, 158 Shangtang Road, 310014 Hangzhou, Zhejiang, China. Electronic address: zhangxin120189@hotmail.com.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Oncology and Department of Clinical and Experimental Medicine, Linkoping University, SE-581 85 Linkoping, Sweden. Electronic address: xiao-feng.sun@liu.se.
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of General Surgery, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University, 85 Wujin Road, 200080 Shanghai, China. Electronic address: pengpzhh@hotmail.com.
authors.forename: Zhihai
authors.initials: Z
authors.lastname: Peng
authors.affiliation: Department of General Surgery, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University, 85 Wujin Road, 200080 Shanghai, China; Department of Oncology and Department of Clinical and Experimental Medicine, Linkoping University, SE-581 85 Linkoping, Sweden. Electronic address: wenyg1502@163.com.
authors.forename: Yugang
authors.initials: Y
authors.lastname: Wen
mesh_terms: D000368:Aged; D003106:Colon / Q000378:metabolism / Q000473:pathology*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000473:pathology*; D018450:Disease Progression; D015536:Down-Regulation; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D018398:Homeodomain Proteins / Q000032:analysis / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012007:Rectum / Q000378:metabolism / Q000473:pathology*; D016019:Survival Analysis
chemical_list: C491320:BARX2 protein, human; D018398:Homeodomain Proteins
keywords: Barx2; Colorectal cancer; Prognosis; Progression