Expression of the membrane complement regulatory protein CD59 (protectin) is associated with reduced survival in colorectal cancer patients

Abstract

It has been known for some time that the immune system can recognise growing tumours, and that tumours may respond by modulation of molecules, which make them resistant to further attack. Expression, over-expression, or loss of these molecules may function as markers of tumour progression and prognosis. Among such molecules are the membrane-bound complement regulatory proteins (mCRP), which protect cells from bystander attack by autologous complement. These include CD59 (protectin), which prevents formation of the MAC complex in the terminal stages of complement activation. In the present study, we evaluated immunohistochemical expression of CD59 in a series of over 460 well-characterised colorectal cancers using tissue microarrays (TMA), and related this information to known tumour and patient variables and to survival. The CD59 expression was observed in 69 (15%) of cases overall, and was significantly associated with tumour grade. In contrast, no associations were noted with tumour site, stage or histological type. On survival analysis, a further correlation was observed between expression of CD59 by the colorectal tumours and a reduction in disease-specific patient survival. This observation was strongest for patients with early stage disease. However, a negative impact on survival was also seen in those patients with late stage disease. These results indicate that TMA linked to good clinicopathological databases with good long term follow up are useful tools for determining new prognostic indicators that can be used in future patient management. Immune surveillance may result in immune-editing that induces variable expression of a range of target antigens, and these may be useful prognostic markers. This study has identified CD59 expression as a marker of poor prognosis in colorectal cancer patients.

Fig. 1

a Colorectal TMA core stained with anti-CD59 antibody (1:10 dilution) demonstrating positive CD59 expression in tumour cell cytoplasm and at luminal membrane. b Colorectal TMA core from the same slide with absent tumour expression of CD59. Note strongly positive staining of vascular endothelial cells acting as internal positive control (both at 20 times original magnification)

Fig. 2

a Kaplan–Meier plot for all patients showing disease-specific survival for CD59 positive/negative tumours (n=449). b Kaplan–Meier plot for TNM stage 0/I/II patients (n=242). c Kaplan–Meier plot for TNM stage III/IV patients (n=207)