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Gene Linked to Lower Survival in Colorectal Cancer Patients

Expression of GUCY2C in histologically negative lymph nodes seen as a measure of metastasis

TUESDAY, Feb. 17 (HealthDay News) -- Colorectal cancer patients whose lymph nodes are histologically negative but produce a marker of lymph node metastasis have an earlier time to recurrence and lower disease-free survival, researchers report in the Feb. 18 issue of the Journal of the American Medical Association.

Scott A. Waldman, M.D., Ph.D., from Thomas Jefferson University in Philadelphia, and colleagues prospectively examined the association between expression of the guanylyl cyclase 2C (GUCY2C) gene at the messenger RNA level in histologically negative lymph nodes (as a measure of occult metastases) and recurrence and survival in 257 patients with colorectal cancer.

After a median of 24 months, the investigators found that the lymph nodes of 32 patients (12.5 percent) were negative for GUCY2C, and 30 remained disease-free (recurrence rate 6.3 percent). In the 225 patients with lymph nodes positive for GUCY2C, the researchers report that 47 (20.9 percent) had recurrent disease. After adjusting for confounding factors, GUCY2C expression in lymph nodes independently predicted prognosis. Patients positive for expression had an earlier time to recurrence (adjusted hazard ratio, 4.66) and reduced disease-free survival (adjusted hazard ratio, 3.27), the report indicates.

"Expression of GUCY2C in histologically negative lymph nodes appears to be independently associated with time to recurrence and disease-free survival in patients with [histologically lymph node-negative] colorectal cancer," Waldman and colleagues conclude.

Two study authors disclosed relationships with Targeted Diagnostic and Therapeutics Inc., which also provided partial funding for the study.

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