Effect of preoperative short-term adjuvant chemotherapy on the expression of CDX2 and growth inhibitory factor 4 in colorectal cancer patients

Objective To evaluate the clinical efficacy of preoperative short-term adjuvant chemotherapy combined with radical surgery for colorectal cancer (CRC) patients, and the effect on the expression of tissue CDX2 and growth inhibitory factor 4 (ING4). Methods From January 2013 to December 2016, the data of one hundred and twelve patients with CRC in Rugao Boai Hospital were analyzed retrospectively. Thirty-two patients underwent radical resection (control group), 80 patients received short range adjuvant chemotherapy before radical surgery (test group). The biopsies expressions of CDX2 and ING4 in two groups were analyzed by immunohistochemistry. The recovery during perioperative period, anal exhaust time, ambulation time, hospitalization time and complications of the patients were analyzed. The follow-up data were collected for univariate survival analysis by Kaplan-Meier survival curves. Results (1) The basic pathological data of the patients between the two groups were not statistically significant. (2) The scoring and positive rates of CDX2 and ING4 were comparable between the two groups without significant difference. The post-operative histochemical scoring of CDX2 and ING4 of the test group were 8.33±1.86 and 8.86±2.31 (positive rate: 83.75% and 72.50%, respectively), significantly higher than the control group (5.86±2.41 and 6.83±1.57, positive rate: 59.38% and 53.13%) and pre-operative level (6.55±2.09 and 6.95±2.13, positive rate: 59.38% and 57.50%). (3) Compared with the control group, the ambulation time of the test group was earlier (P=0.033), while no statistically significant difference was detected for anal exhaust time (P=0.235) and hospitalization time (P=0.332). (4) The mortality rate of the test group during the 39-month follow-up was significantly lower than the control group (6.25% vs 15.63%, P<0.05). Conclusion Preoperative short-term adjuvant chemotherapy can significantly improve the expression of CDX2 and ING4 protein in colorectal cancer patients, and improve the prognosis by providing certain inhibitory effect on the lesion. Key words: Colorectal neoplasms; Chemotherapy, adjuvant; Colorectal surgery; Inhibitor of growth protein 4; CDX2