for better or worse clinical correlation of sox9 and
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For Better or Worse: Clinical Correlation of SOX9 and Irradiated Rectal Cancer Xiuzhen Duan, Brandon Trac, and Xianzhong Ding, Department of Pathology Loyola University Medical Center Maywood, IL 60153 USA SOX9 and Cancer Stem-like Cells

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  1. For Better or Worse: Clinical Correlation of SOX9 and Irradiated Rectal Cancer Xiuzhen Duan, Brandon Trac, and Xianzhong Ding, Department of Pathology Loyola University Medical Center Maywood, IL 60153 USA

  2. SOX9 and Cancer Stem-like Cells • it is well accepted that cancer stem-like cells are the main driving force behind tumor formation, metastasis, and chemoresistance • Cancer stem like cells exhibit diverse cell properties including self renewal, differentiation capacity, and resistance to apoptosis and chemotherapy

  3. SOX9 • Sex-determining region Y (SRY)-box 9 protein (SOX9) is a member of the SOX family of transcription factors • SOX9 participates in a variety of functions, such as tumor cell differentiation, stem-like cell lineage formation and epithelial mesenchymal transition • Role of SOX9 in colon cancer: controversial • Effect of chemoradiation on SOX9 expression unclear

  4. Aims and Methods • The objectives of this study is examining SOX9 expression in pre- and post-irradiated rectal cancer • 25 patients with locally advanced rectal cancer – Moderately differentiated adenocarcinoma – Received neoadjuvant chemoradiation therapy followed by surgery

  5. Aims and Methods • SOX9 expression – Evaluated by IHC – 4-tier grading system • 0: no expression • 1: low expression • 2: moderate expression • 3: high expression – Percentage of SOX9 positive cells

  6. Pre-CRT post-CRT Pre-CRT post-CRT Non-tumor mucosa Adenocarcinoma

  7. Pre-CRT post-CRT Pre-CRT post-CRT Non-tumor mucosa Adenocarcinoma

  8. SOX9 expression and tumor response to neoadjuvant therapy • 2 cases with complete response to neoadjuvant therapy – High expression of SOX9 • No correlation of tumor volume reduction and SOX9 expression prior to chemotherapy • No association with lymph node metastasis and late distant metastasis

  9. Conclusions • Role of SOX9 in colon cancer is still controversial • Might be a potential marker to predict tumor response to chemoradiation and oncological outcomes • Large cohort studies are needed to be conclusive

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