title: Prognostic Value of E-cadherin-, CD44-, and MSH2-associated Nomograms in Patients With Stage II and III Colorectal Cancer.
abstract: BACKGROUND
  To evaluate the prognostic value of E-cadherin, CD44, and MSH2 expression for colorectal cancer (CRC) and construct nomograms that can predict prognosis.
  
  
  METHODS
  We retrospectively analyzed the expression of E-cadherin, CD44, and MSH2 in 223 paraffin-embedded stage II and III CRC specimens using immunohistochemistry in the training cohort. Their prognostic values were assessed using Kaplan-Meier curves and univariate and multivariate COX regression models. Moreover, a number of risk factors were used to form nomograms to evaluate survival, and Harrell's concordance index (C-index) was used to evaluate the predictive accuracy. Further validation of the nomograms was performed in an independent cohort of 115 cases.
  
  
  RESULTS
  Low E-cadherin expression and low CD44 expression were significantly associated with diminished overall survival (OS) and disease-free survival (DFS) in stage II and III CRC patients and patients with negative MSH2 expression had better clinical outcomes. Moreover, the multivariate COX analysis identified E-cadherin, CD44 and MSH2 expression as independent prognostic factors for DFS and OS. Using these three markers and three clinicopathological risk variables, two nomograms were constructed and externally validated for predicting OS and DFS (C-index: training cohort, 0.779 (95% CI 0.722-0.835) and 0.771 (0.720-0.822), respectively; validation cohort, 0.773 (0.709-0.837) and 0.670 (0.594-0.747), respectively).
  
  
  CONCLUSIONS
  The expression levels of E-cadherin, CD44 and MSH2 were independent prognostic factors for stage II and III CRC patients. By incorporating clinicopathological features and these biomarkers, we have established two nomograms that could be used to make individualized predictions for OS and DFS.
authors.affiliation: Department of General Surgery, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, China; Department of Surgical Oncology, The first Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Jinmiao
authors.initials: J
authors.lastname: Qu
authors.affiliation: Department of General Surgery, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, China; Guangdong Key Laboratory of Liver Disease Research, the 3rd Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China.
authors.forename: Yuming
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Department of General Surgery, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of General Surgery, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, China.
authors.forename: Haijun
authors.initials: H
authors.lastname: Deng
authors.affiliation: Department of General Surgery, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Yu
authors.affiliation: Department of General Surgery, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, China.
authors.forename: Xiaolong
authors.initials: X
authors.lastname: Qi
authors.affiliation: Cancer Institute, the 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hanzhou, 310009, China; Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, the 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hanzhou, 310009, China.
authors.forename: Weiting
authors.initials: W
authors.lastname: Ge
authors.affiliation: Department of General Surgery, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, China. Electronic address: gzliguoxin@163.com.
authors.forename: Guoxin
authors.initials: G
authors.lastname: Li