title: Loss of APAF-1 expression is associated with early recurrence in stage I, II, and III colorectal cancer.
abstract: OBJECTIVE
  Apoptotic protease activating factor-1 (APAF-1) is a key regulator in the mitochondrial apoptotic pathway and an important diagnostic and therapeutic biomarker. Loss of APAF-1 expression has been observed in various tumors including colorectal cancer. The aim of our study was to evaluate the relationship between loss of APAF-1 expression and early recurrence of stage I-III colorectal cancer.
  
  
  METHODS
  We investigated 165 out of 492 patients who had undergone curative resection for colorectal cancer between 1991 and 2001. Sixty-one patients (37.0 %) had early recurrence within 1 year after surgery. Tissue microarrays were used for immunohistochemical detection of APAF-1.
  
  
  RESULTS
  The mean age of patients with recurrence was 58 years (range, 24-85); 88 (53.3 %, 88/165) were male. APAF-1 was expressed in 32 (19.4 %, 32/165) cases and was not expressed in 133 (80.6 %, 133/165). In univariate analysis, early recurrence significantly correlated with loss of APAF-1 expression (p = 0.017), tumor stage (p = 0.005), N category (p = 0.001), and lymphatic invasion (p = 0.008). In a logistic regression model, loss of APAF-1 expression (p = 0.015, 95 % CI = 1.280-10.063) and N category (p = 0.001, 95 % CI = 0.004-0.739) proved to be independent risk factors associated with early recurrence. In patients with lymph node metastasis, early recurrence was more frequent in the APAF-1-negative group than in the APAF-1-positive group (46.2 % (54/117) vs. 22.2 % (6/27), p = 0.023).
  
  
  CONCLUSIONS
  Loss of APAF-1 expression is associated with early recurrence in stage I-III colorectal cancer, suggesting that APAF-1 may have clinical value as a predictive marker of early recurrence.
authors.affiliation: Department of Surgery, College of Medicine, Hanyang University, 222-1, Wangsimni-ro, Seongdong-gu, Seoul, 133-792, Korea.
authors.forename: Byung Kyu
authors.initials: BK
authors.lastname: Ahn
authors.affiliation: Department of Surgery, College of Medicine, Hanyang University, 222-1, Wangsimni-ro, Seongdong-gu, Seoul, 133-792, Korea.
authors.forename: Sung Hoo
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Pathology, College of Medicine, Hanyang University, Seoul, Korea.
authors.forename: Seung Sam
authors.initials: SS
authors.lastname: Paik
authors.affiliation: Department of Surgery, College of Medicine, Hanyang University, 222-1, Wangsimni-ro, Seongdong-gu, Seoul, 133-792, Korea. leekh@hanyang.ac.kr.
authors.forename: Kang Hong
authors.initials: KH
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053477:Apoptotic Protease-Activating Factor 1 / Q000378:metabolism*; D003110:Colonic Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology / Q000378:metabolism* / Q000473:pathology; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
chemical_list: C506592:APAF1 protein, human; D053477:Apoptotic Protease-Activating Factor 1
keywords: APAF-1; Colorectal cancer; Early; Recurrence