Clinicodemographical assessment of colorectal cancer with emphasis on B3GALNT2, MUC1, P53 and Ki67-related risk of metastasis

Abstract Background: The incidence of colorectal cancer (CRC) is rising, worldwide, and is attributed to genetics and epigenetic factors. We aimed to evaluate the key clinicodemographical/epidemiological-and molecular impacts on metastatic CRC in CRC patients from a highly populated area in northeastern Iran. Retrospective clinical materials-based cohort design and patients were analyzed with respect to age, sex, colorectum anatomy, metastasis, mortality as well as to expression of molecular markers B3GALNT2, mucin I ( MUC1), P53 and Ki67. Methods: Patients, 6260 registered CRC with 3829 underwent surgery, from three medical university hospitals in the study area, during 2006-2016, were analyzed for the clinicodemographic aspects of age, sex, stage of CRC, history of smoking, familial/occupational status and post-surgery survival period as well as mRNA/protein expression of B3GALNT2, MUC1, P53 and Ki67. Factors were set to estimate mortality and risk of metastatic CRC. Results: ~61%, ~33% and ~6% of adenocarcinomatous CRC were located in colon, rectum and rectosigmoid, respectively, of which younger-and older than 50 was mainly in transvers colon-and colorectum, respectively. Post-surgery survival period of metastatic CRC patients was remarkably longer in patients aged > 50 than those < 50 years old, and worse in females than males. B3GALNT2 high , MUC1 high , P53 low and Ki67 high mRNA/protein expression in metastatic stage III CRC were highly associated with increased metastasis and mortality. B3GALNT2 high , MUC1 high , P53 low and Ki67 high mRNA/protein expression correlated with increased risk of a progressed CRC state and mortality. The risk to develop metastatic CRC was higher in males, younger, urban residing-and employed individuals, indicative of a plausible non-genetics/epigenetics contribution to CRC. Conclusions: The role of possible diagnostic biomarkers, B3GALNT2, MUC1 and Ki67, but not P53, in the etiology/early detection of metastatic CRC is promising. Epigenetic contribution to metastatic CRC risk is predominant.