Prognostic role of HIF-1 ALPHA, CA9 and CXCR4 immunohistochemical expression in colorectal carcinomas

Colorectal carcinoma is common in our country and worldwide. It is still a cause of high mortality and morbidity for both genders.For now, TNM staging is the gold standart prognostic parameter for colorectal carcinoma. However, remarks about different clinical behaviour of patients at the same stage necessitate to search for new prognostic parameters.One hundred and eighty six colorectal carcinoma cases, diagnosed at the Pathology Department of Gazi University Medical School and clinically followed by the Oncology Department, were included in this study. Our aim was to analyse the immunohistochemical expression of HIF-1?, CXCR4 and CA9 in resection materials and find their relation with patients? clinic features (age, gender), tumour localization, tumour dimension, macroscopic growth pattern, histologic type, grade, angiolymphatic invasion, TNM stage, liver metastasis, local recurrence and overall survival. This way we planned to determine the prognostic significance of these immunohistochemical markers.Ninety-four percent of the operative samples showed nuclear positivity with HIF-1?. Eighty-nine percent of cases showed cytoplasmic CXCR4 expression. CA9 membranous expression was seen in fifteen percent of the cases. Immunhistochemical expression of none of these markers were related to major prognostic parameters as angiolymphatic invasion, T, N, M categories, stage and overall survival. CXCR4 expresion was significantly higher in grade 1-2 tumours compared with grade 3. But we did not find any correlation between the grade and CA9 and HIF-1? expression.This study showed that, prognostic significance of these three markers is very limited in colorectal carcinomas. Although they appear to be poor prognostic factors based on their role in the biochemical pathways of carcinogenesis, we did not find any evidence for this.In conclusion, to clarify the conflicting results in the literature, and to determine the role of these markers for treatment, there must be larger prospective studies with standardized technical methods.Keywords: Prognostic parameters in colorectal carcinoma, HIF-1?, CXCR4, CA9