Immunohistochemical Expression of Fascin-1 in Colorectal Carcinoma and Its Association with Pathological Grade and Stage.
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OBJECTIVE: To evaluate the expression of Fascin-1 in colorectal carcinoma and analyse its association with clinicopathological parameters and pathological stage. STUDY DESIGN: A cross-sectional Study. Place and Duration of the Study: Department of Pathology, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan, from July 2022 to June 2023. METHODOLOGY: Surgical resection specimens of colorectal carcinoma underwent histopathological processing for the preparation of haematoxylin and eosin-stained slides. Immunohistochemical evaluation for the biomarker Fascin-1 was then performed, and its expression was evaluated according to standard criteria. RESULTS: There was a total of 73 cases of colorectal cancer in this study. The mean age of patients was 44.76 ± 15.83 years (13-75 years). Histopathological subtype adenocarcinoma NOS was the most common finding on microscopic examination. Moderately differentiated tumours were the most frequent finding (63%, n = 46). In this study, most tumours were of the rectosigmoid region (26%, n = 19). Fascin-1 had positive expression in 46.6% (n = 34) cases. In histopathologic subtype, poorly differentiated tumours had a statistically significant expression of Fascin-1 (p = 0.001). ROC curve analysis of the continuous Fascin-1 product score against pathological stage demonstrated excellent predictive performance (AUC = 0.859, p <0.001). Multivariate analysis demonstrated higher expression of Fascin-1 to be a significant predictor of advanced stage (OR = 6.131, 95% CI: 1.197-31.410; p = 0.030). However, lymphovascular invasion (p = 0.082), tumour deposits (p = 0.798), and tumour grade (p = 0.315) did not show a significant association with advanced stage. CONCLUSION: Fascin-1 expression is significantly associated with advanced tumour stage in colorectal carcinoma. Independent association of Fascin-1 with staging in multivariate analysis suggests its potential role as a biomarker for tumour progression. Its higher expression in poorly differentiated tumours and signet ring cell carcinoma also supports its role in tumour aggressiveness. KEY WORDS: Colorectal neoplasms, Fascin-1, Immunohistochemistry, Neoplasm grading, Neoplasm staging.