Immunohistochemistry predictive markers for primary colorectal cancer tumors: where are we and where are we going?

Vol. 59 No. 1, 2018


Alexandru Barbalan, Andrei Cristian Nicolaescu, Antoanela Valentina Magaran, Razvan Mercut, Maria Balasoiu, Gabriela Bancescu, Mircea-Sebastian Serbanescu, Octavian Fulger Lazar, Adrian Saftoiu

The aim of our study is to highlight and organize the recently published immunohistochemistry (IHC) predictive biomarkers of primary colorectal cancers (CRCs) that could lead to practical implementation. We reviewed articles that examined CRC samples with significant statistic correlation between the IHC marker expression and disease progression over time, relationships with the available clinical features and those who detect the prognosis of drug effects. Our analysis showed that nine markers could correlate with medical treatment response of CRCs in different stages. When using better overall survival (OS) and better disease-free survival (DFS) as a grouping factor, there were 14 markers that could be used in assessing CRC prognosis. By using poor prognostic for the OS and the DFS as a grouping factor, we found 43 markers. Subgroup analysis was also performed based on the 32 markers recently confirmed to predict metastasis evolution or the recurrence risks. Venous invasion could be predictable for tumors, statistically significant metastasis susceptibility was observed for markers and also the capacity to evaluate recurrence. CRCs integrate a variety of localizations and there are proofs that distinguish the sites of tumors. The studies reporting data specifically for rectal cancer separating it from colon cancer contained seven IHC markers. In order to be able to implement a predictive biomarker in clinical practice, it must comply with certain criteria as clinical value and analytical proof. Unique biological signature of CRC can be distinguished by identifying biomarkers expression. Several markers have shown potential, but the majority still need to render clinical utility.

Corresponding author: Razvan Mercut, Assistant Professor, MD, PhD; e-mail:; Octavian Fulger Lazar, Professor, MD, PhD; e-mail:

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