The distinguished predictive value of CFIm25 in schistosomal and non-schistosomal colorectal cancer.

BACKGROUND: The impact of CFIm25 expression on the prognosis of colorectal cancer (CRC) has rarely been reported, and only limited studies have focused on CRC associated with Schistosoma japonicum infection. This study aimed to investigate the prognostic value of CFIm25 in CRC, with emphasis on its distinct prognostic role in schistosomal CRC (SCRC) and non-schistosomal CRC (NSCRC). METHODS: A total of 286 CRC cases from Qingpu Branch of Zhongshan Hospital, Fudan University were retrospectively analyzed using tissue microarrays. CFIm25 expression was assessed by immunohistochemical staining, and its relationship with clinicopathological characteristics and clinical outcomes were evaluated. RESULTS: Gender, tumor node metastasis (TNM) stage, lymph node positive, and CFIm25 expression were identified as independent prognostic factors associated with overall survival (OS) in the whole cohort. Patients were further stratified according to schistosomal infection status into NSCRC and SCRC subgroups. CFIm25 was a beneficial prognostic predictor in patients with NSCRC. CFIm25 expression had no significant effect on OS in patients with stage I-II tumors or in those without lymph node metastasis, whereas it was an independent prognostic factor in patients with stage III-IV tumors and in those with lymph node metastasis. Moreover, CFIm25 expression was negatively correlated with aggressive clinicopathological features, including advanced TNM stage, poor tumor differentiation, lymph node metastasis, and lympho-vascular invasion. CONCLUSIONS: CFIm25 was identified as a prognostic factor in the overall CRC cohort, but its prognostic significance varied across different subgroups. CFIm25 may serve as a useful biomarker for risk stratification, particularly in NSCRC and advanced disease.