Reduced expression of alpha catenin is associated with poor prognosis in colorectal carcinoma

Aims-To investigate a catenin expression in surgically resected human color ectal cancers to evaluate its prognostic value during long term follow up. Methods-Immunohistochemistry was used to compare the expression of alpha ca tenin with conventional prognostic factors in 187 colorectal cancer patient s treated in Kuopio University Hospital and followed up for a mean of 14 ye ars. The hypothesis that the intensity of expression of a catenin and its d istribution in cancer cells is correlated with survival was tested with the log-rank test, hazard ratios, and their confidence intervals. Results-Uniform membranous a catenin staining localised to the intercellula r borders was observed in 46% of the tumours; 55% of all tumours had either heterogeneous or negative a catenin expression, and staining intensity was either negative or weak in 42% of the tumours. The cancer related and recu rrence-free survival rates were lower among patients with a weak a catenin intensity in tumour epithelium (p < 0.001), a low fraction of positive tumo ur cells (p < 0.001), and an additional cytoplasmic accumulation of alpha c atenin (p < 0.001). In multivariate analysis, the intensity of alpha cateni n expression in tumour epithelium predicted cancer related survival indepen dently; alpha catenin localisation in tumour epithelium was an independent prognostic factor of recurrence-free survival in the group as a whole and i n the T1-3N0M0 tumour subgroup. Conclusions-A low proportion of positive carcinoma cells, additional cytopl asmic accumulation of a catenin, and reduced expression intensity in tumour epithelium predict a poor survival rate. The results suggest that alpha ca tenin has prognostic significance in colorectal cancer.