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. 2017:2017:2520581.
doi: 10.1155/2017/2520581. Epub 2017 Jun 28.

Epithelial-Mesenchymal Transition Phenotype, Metformin, and Survival for Colorectal Cancer Patients with Diabetes Mellitus II

Yaodu Wang  1 , Zhiyang Wu  2 , Likuan Hu  1
Affiliations

Epithelial-Mesenchymal Transition Phenotype, Metformin, and Survival for Colorectal Cancer Patients with Diabetes Mellitus II

Yaodu Wang et al. Gastroenterol Res Pract. 2017.

Abstract

Objectives: We aimed to explore the association between metformin treatment and epithelial-mesenchymal transition (EMT) phenotype and further appraise the prognostic values of metformin and EMT markers E-cadherin and vimentin for colorectal cancer (CRC) in clinical practice.

Methods: We collected specimens and evaluated clinicopathological parameters of 102 stage I to III CRC patients with prediagnosed type 2 diabetes mellitus (DM II). Expression of E-cadherin and vimentin in tumors was detected by immunohistochemistry (IHC), and statistical analysis was performed using SPSS 19.0.

Results: In correlation tests, we found a lower tumor cell EMT degree (more E-cadherin (P = 0.014) and less vimentin (P = 0.011) expression in patients who used metformin, and the expression of E-cadherin and vimentin was associated with serum CA19-9 (P = 0.048, P = 0.009), tumor invasive depth (T) (P < 0.001, P = 0.045), and lymph invasion (N) (P = 0.013, P = 0.001). In Cox multivariate regression analysis, E-cadherin was identified as a prognostic factor for disease-free survival (DFS) (P = 0.038) and metformin use (P = 0.015P = 0.044) and lymph invasion (P = 0.016P = 0.023) were considered as the prognostic factors for both DFS and overall survival (OS).

Conclusion: Our study suggested that metformin may impede the EMT process and improve survival for stage I-III CRC patients with DM II.

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Figures

Figure 1
Figure 1
Representative pictures by immunohistochemistry for E-cadherin and vimentin expression in specimen. (Magnification ×400) E-cadherin expression: (a) negative expression, (b) low expression, and (c) high expression. Vimentin expression: (d) negative expression, (e) low expression, and (f) high expression.
Figure 2
Figure 2
IHC scores of E-cadherin and vimentin in CRC tissues from patients with or without metformin: compared with patients without metformin, patients with metformin expressed higher E-cadherin (P < 0.001) and lower vimentin (P = 0.001).
See this image and copyright information in PMC

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