Circadian protein Cry2 is a prognostic factor of colorectal cancer and a predictor of chemotherapy

AIM:To assess the association between the expression of Cry2 and the prognosis of colorectal cancer for determining the role of Cry2 in predicting the outcome of chemotherapy. METHODS:Sixteen primary colorectal cancer patients who consecutively underwent neoadjuvant chemotherapy with 5-fluorouracil were enrolled in the present study. The tumor specimens were obtained by colonscopy prior to treatment. The tumor response was evaluated by the response evaluation criteria in solid tumors(RECIST). Accordingly, the patients were divided into 2 groups:complete response(CR)/partial response(PR) and stable disease(SD)/progress disease(PD). Two-tail ² test was applied to analyze the data. In parallel, we assessed 307 patients, who underwent tumor resection between 2001 and 2005. Survival time was calculated from the date of surgery to the date of death or the last follow-up date. Survival curves were obtained by Kaplan-Meier method. Log-rank test was applied for univariate analysis. The Cox proportional hazards regression model was used to identify the independent prognostic factors. RESULTS:The expression of Cry2 was high in CR/PR patients and was low in SD/PD patients, with significant difference(P<0.05). The average survival time of the 84 patients with high expression of Cry2 was 83.458 months, while the average survival time of 223 patients with low expression of Cry2 was 100.10 months, also with significant difference(P<0.05). The patients with low expression of Cry2 lived longer. The multivariate Cox regression analysis indicated that the expression of Cry2 was an independent prognostic factor for colorectal cancer patients(HR was 1.70, 95% CI was 1.09 to 2.66, P<0.05). Multivariate Cox regression showed that high Cry2 expression predicted a worse prognosis(HR was 2.88, 95%CI was 1.03 to 8.06, P<0.05) in colorectal cancer patients with neoadjuvant chemotherapy. CONCLUSION:Expression of Cry2 is an independent prognostic factor for colorectal cancer patients. Lower expression of Cry2 indicates good response to neoadjuvant chemotherapy.