Expressions of ZEB1 of patients with colorectal cancer in Indonesia: Correlations with clinicopathological characteristics and liver metastasis profile

Abstract

Zinc finger E-box binding homeobox 1 (ZEB1) and ZEB2 in the ZEB1/2 isoform complex are known to play an important role in the progression, invasion, and metastasis of colorectal cancer (CRC). In cancer cells, ZEB1 regulates the epithelial-mesenchymal transition (EMT). This study aimed to identify the ZEB1 expression in CRC and its correlation with clinicopathological and metastatic status.  Using reverse transcription-quantitative polymerase chain reaction (RT-qPCR), we compared different ZEB1 expressions in fresh-frozen tissue from non-tumor tissue (NT), primary tumor tissue without metastasis (PT), and primary tumor tissue with liver metastasis (PTLM). The correlation between ZEB1 expression and clinicopathological characteristics was also investigated. Statistical analysis revealed that ZEB1 expression is significantly higher in the primary tumor tissues (PT and PTLM) than in NT (p<0.05), and high ZEB1 expression is associated with PTLM (p<0.05). ZEB1 expression is significantly correlated with white blood cells (p=0.005), blood glucose (p=0.017), tumor invasion (p=0.001), pathological grading (p=0.002) and metastasis profile (p=0.001). There was no significant correlation between ZEB1 expression and age, body mass index, hemoglobin, albumin, platelet count, alanine aminotransferase, aspartate aminotransferase, carcinoembryonic antigen and tumor location. These findings suggest that ZEB1 expression has diagnostic value in predicting tumor progression and detecting liver metastases.