Categorizing desmoplastic reaction (DR) based on the histological findings of cancer-associated fibroblasts is shown to be a promising novel method to predict prognosis of patients with colorectal cancer (CRC). Periostin (POSTN) in cancer-associated stroma is reportedly associated with poor clinical outcomes. Immunohistochemical staining with an anti-POSTN antibody was performed in 73 patients with pStage III CRC (cohort 1). In addition, to evaluate mRNA and protein expression levels of POSTN, we analyzed paired normal and invasive cancer frozen specimens by quantitative real-time polymerase chain reaction and western blot analysis in 41 patients (cohort 2). In cohort 1, according to the DR categorization, 18, 22, and 33 patients were classified as immature, intermediate, and mature, respectively. High immunoreactivity of POSTN was observed 100%, 68.2%, and 27.3%, respectively (p < 0.0001). The 5-year relapse-free survival rates were 56.8% and 82.7% in high and low POSTN expression subgroups, respectively (p = 0.015). In cohort 2, the POSTN mRNA and protein levels were significantly higher in the immature stroma as compared to the stroma characterized as other DR patterns. POSTN expression was closely associated with DR categorization. POSTN may be a key molecule that contributes to the malignant potential of CRC.

基于癌症相关的成纤维细胞的组织学发现对去增生反应（DR）进行分类显示是预测大肠癌（CRC）患者预后的有前途的新方法。据报道，癌症相关基质中的骨膜素（POSTN）与不良的临床预后相关。在73例pStage III CRC患者中进行了抗POSTN抗体的免疫组织化学染色（队列1）。此外，为了评估POSTN的mRNA和蛋白表达水平，我们通过定量实时聚合酶链反应和Western blot分析了41例患者中的正常和浸润癌配对的冰冻标本（组2）。在队列1中，根据DR的分类，分别将18、22和33例患者分为未成熟，中级和成熟患者。观察到POSTN的高免疫反应性100％，p  <0.0001）。高和低POSTN表达亚组的5年无复发生存率分别为56.8％和82.7％（p  = 0.015）。在队列2中，与以其他DR模式为特征的基质相比，未成熟基质的POSTN mRNA和蛋白水平显着更高。POSTN表达与DR分类密切相关。POSTN可能是导致CRC恶性程度的关键分子。