A comparison of gene expression in emergency and elective colon cancer: LTP75

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Aim:Emergency colon cancer (ECC) has a worse stage distribution compared with elective cases. Furthermore, stage-specific long-term survival, postoperative mortality disregarded, is known to be lower in the emergency group. The aetiology for ECC is multi-factorial but we hypothesized that the increased biological aggressiveness has a genetic base. The aim of this study was to compare gene expression in ECC and elective colon cancer.Method:All patients with colon cancer admitted to Eskilstuna GDH, Sweden 1996-2005 were included (n = 605). ECC was defined as admission through the ER, laparotomy within 72 hours and an emergency condition confirmed at surgery (n = 97). Randomly three patients from each group were chosen. Paraffin-embedded tumour tissue was analyzed with micro-array, Ingenuity Pathway software and RT-PCR.Results:Of 30 000 genes analyzed, 1047 were significantly up-and 814 down-regulated in ECC. In particular, the Wnt/β-catenin pathway, regulatingproliferation and apoptosis, differed between the groups. Three intracellularproteins in the Wnt pathway; GSK, LEF-1 and TCF, were up-regulated as well as the extracellularprotein ROR1.Conclusion:For the first time, ECC has been linked with a difference in gene expression. This might have implications for chemotherapy in the future.

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