CD4 and FOXP3 as predictive markers for the recurrence of T3/T4a stage II colorectal cancer: applying a novel discrete Bayes decision rule

Yuki Nakagami; Shoichi Hazama; Nobuaki Suzuki; Shin Yoshida; Shinobu Tomochika; Hiroto Matsui; Yoshitaro Shindo; Yukio Tokumitsu; Satoshi Matsukuma; Yusaku Watanabe; Michihisa Iida; Ryouichi Tsunedomi; Shigeru Takeda; Tomonobu Fujita; Yutaka Kawakami; Hiroyuki Ogihara; Yoshihiko Hamamoto; Tatsuya Ioka; Tsuyoshi Tanabe; Tomio Ueno; Hiroaki Nagano

doi:10.1186/s12885-022-10181-7

CD4 and FOXP3 as predictive markers for the recurrence of T3/T4a stage II colorectal cancer: applying a novel discrete Bayes decision rule

BMC Cancer. 2022 Oct 18;22(1):1071. doi: 10.1186/s12885-022-10181-7.

Authors

Yuki Nakagami^{1

2

3}, Shoichi Hazama^{1

2}, Nobuaki Suzuki², Shin Yoshida², Shinobu Tomochika², Hiroto Matsui², Yoshitaro Shindo², Yukio Tokumitsu², Satoshi Matsukuma², Yusaku Watanabe², Michihisa Iida², Ryouichi Tsunedomi², Shigeru Takeda², Tomonobu Fujita⁴, Yutaka Kawakami⁴, Hiroyuki Ogihara^{5

6}, Yoshihiko Hamamoto⁵, Tatsuya Ioka⁷, Tsuyoshi Tanabe³, Tomio Ueno⁸, Hiroaki Nagano⁹

Affiliations

¹ Department of Translational Research and Developmental Therapeutics Against Cancer, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan.
² Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan.
³ Department of Public Health and Preventive Medicine, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan.
⁴ Division of Cellular Signaling, Institute for Advanced Medical Research, Keio University School of Medicine, Shinjuku, Tokyo, Japan.
⁵ Division of Electrical, Electronic and Information Engineering, Graduate School of Sciences and Technology for Innovation, Yamaguchi University, Ube, Yamaguchi, Japan.
⁶ Department of Computer Science and Electronic Engineering, National Institute of Technology, Tokuyama College, Shunan, Yamaguchi, Japan.
⁷ Department of Oncology Center, Yamaguchi University Hospital, Ube, Yamaguchi, Japan.
⁸ Department of Digestive Surgery, Kawasaki Medical University, Kurashiki, Okayama, Japan.
⁹ Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan. hnagano@yamaguchi-u.ac.jp.

Abstract

Background: We recently reported the relapse-free survival (RFS) significance of the combination of CD4⁺ and forkhead box P3⁺ (FOXP3) T-cell densities identified by immunohistochemistry in patients with stage I, II, and III colorectal cancer (CRC) who underwent curative resections. This study was designed to determine the optimal combination of markers that predict recurrence in patients with T factors of T3/T4a stage II CRC by applying a novel Bayes decision rule.

Methods: Using 137 cancer tissue specimens from T3/T4a stage II patients, 12 clinicopathologic and immune factors were analysed as predictive candidates for recurrence.

Results: Our study showed that the combination of low CD4⁺ and low FOXP3⁺ T-cell densities resulted in extremely poor RFS.

Conclusions: Adjuvant chemotherapy may be considered for patients with a combination of low CD4⁺ and low FOXP3⁺ T-cell densities. The discovery of this new prognostic indicator is important for the appropriate management of patients undergoing curative resection for T3/T4a stage II CRC.

Keywords: CD4; Colorectal cancer; Discrete Bayes decision rule; Forkhead box P3; Prognosis.

MeSH terms

Bayes Theorem
Biomarkers
Colorectal Neoplasms* / pathology
Forkhead Transcription Factors*
Humans
Neoplasm Recurrence, Local / pathology
Neoplasm Staging
Prognosis

Substances

Biomarkers
FOXP3 protein, human
Forkhead Transcription Factors

Abstract

MeSH terms

Substances

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