Abstract 4918: Emerging prognostic biomarkers in colorectal cancer: HURP and ZEB1
Authors: Fair Logan , Espinoza Ingrid , Zhang Xu , Elkhattouti Abdelouahid , Ma Tangeng , King Joy , Tarsi Elizabeth , Whitlock Richard , Kannuthurai Vijay , Jimenez Ryan , Craft Tara , Graichen Mary , Lobert Sharon , Duhe Roy , Subramony Charulochana , Lahr Christopher , Gomez Christian R. 
Published: July 2016

Abstract
The current diagnosis of colorectal cancer (CRC) is based on tumor-node-metastasis staging. This classification system has weaknesses due to different genetic and epigenetic backgrounds. Biological markers would improve early detection and guide clinicians in subsequent treatment decisions. Stem-like molecules have the potential to identify patients at high risk of developing aggressive carcinomas. Herein, Hepatoma Up-Regulate Protein (HURP) and Zinc finger E-box binding homeobox 1 (ZEB1) are assessed as potential prognostic biomarkers in CRC. Tumors (N = 21) obtained from colectomies and 5 μm formalin-fixed paraffin-embedded blocks were sectioned and immunostained for HURP and ZEB1. For certain cases (N = 8), flash frozen tissues from tumor and adjacent normal colonic tissue were used to extract total RNA, synthesize cDNA, and perform RT-PCR. Presence of tumor cells in analyzed tissue sections was assessed by a pathologist. HURP mRNA expression was 4-fold higher (p = 0.0005) in tumor tissue relative to adjacent normal tissue. Furthermore, an increase in HURP expression was evident in all tumor samples relative to their respective normal tissue control with an average 3-fold increase (p = 0.001). Immunohistochemical analysis (IHC) of HURP revealed expression in all analyzed specimens. Although the stroma was weakly stained for HURP in some cases, all tumors were immunostained for this protein (average intensity score = ++, p&lt;0.0001). These results suggest HURP's potential as a tumor marker in CRC. ZEB1 mRNA expression in tumors did not differ from that observed in normal adjacent tissue; moreover, a tendency of mRNA to a decrease (n.s.) was observed. IHC for ZEB1 showed immunostaining in all analyzed cases. Weak staining was observed in both tumor and stroma (average intensity score = ++, n.s.). Further stratification of patients by race revealed that in Caucasian-American (CA) patients, staining of ZEB1 was less likely to be associated with disease progression or death after at least 2 years of follow-up. Interestingly, samples obtained from African-American (AA) individuals, known to have worse CRC outcomes, had an association between ZEB1 presence and poor survival regardless of the immunostaining intensity. These findings suggest that IHC localization of ZEB1 may represent a marker of a poor CRC prognosis, particularly in AA patients. However, one must be careful not to over-interpret these results as a Fischer's Exact test revealed a non-significant p value = 0.387. Overall, we have identified two stem cell-like molecules, HURP and ZEB1, with potential as markers of aggressiveness in CRC. Our findings also provide evidence of a possible biological basis for ethnicity-related differences with regards to stemness and regulatory factors of CRC aggressiveness. Future goals include collecting additional samples and expanding the project to examine other potential prognostic markers through IHC analysis of tissue microarrays.
Citation Format: Logan Fair, Ingrid Espinoza, Xu Zhang, Abdelouahid Elkhattouti, Tangeng Ma, Joy King, Elizabeth Tarsi, Richard Whitlock, Vijay Kannuthurai, Ryan Jimenez, Tara Craft, Mary Graichen, Sharon Lobert, Roy Duhe, Charulochana Subramony, Christopher Lahr, Christian R. Gomez. Emerging prognostic biomarkers in colorectal cancer: HURP and ZEB1. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 4918.