Abstract
OBJECTIVE: To investigate the association between the expression levels of galectin-9 and sonic hedgehog (SHH) and the risk of occurrence and prognosis in patients with colorectal cancer (CRC). METHODS: A total of 210 patients with CRC treated at Qingdao Traditional Chinese Medicine Hospital between May 2020 and May 2022 were retrospectively included. The expressions of galectin-9 and SHH in tumor tissues were measured. Logistic regression was used to analyze the relationship between galectin-9/SHH expression and CRC risk. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of galectin-9 and SHH for CRC risk and prognosis. RESULTS: The expression levels of galectin-9 and SHH differed significantly between cancer tissues and adjacent normal tissues (P<0.05). ROC analysis showed that the AUCs for galectin-9 and SHH in evaluating CRC risk were 0.809 (95% CI: 0.751-0.868) and 0.865 (95% CI: 0.817-0.912), respectively. Galectin-9 expression was lower in patients with T(3-4) stage, N(1-3) stage, M(1) stage, or poor differentiation (P<0.05), whereas SHH expression was higher in these patients(P<0.05). Galectin-9 expression was negatively correlated with SHH expression and TNM stage (r=－0.184 and －0.362, respectively; P<0.001). SHH expression was positively correlated with TNM stage (r = 0.407, P< 0.001). Significant differences in galectin-9 and SHH expression were observed between patients with poor prognosis and those with good prognosis (P< 0.05). Logistic regression analysis indicated that T(3-4) stage (OR= 4.609, 95% CI: 1.461-14.535), poor differentiation (OR=3.337, 95% CI: 1.297-8.582), and high SHH expression (OR= 2.067, 95% CI: 1.162-3.678) were risk factors for poor prognosis (P< 0.05), while high galectin-9 expression (OR = 0.652, 95% CI: 0.437-0.975) was a protective factor (P< 0.05). The AUCs of galectin-9 and SHH for evaluating CRC prognosis were 0.769 (95% CI: 0.550-0.798) and 0.734 (95% CI: 0.603-0.866), respectively. CONCLUSION: Galectin-9 and SHH are lowly and highly expressed, respectively, in CRC. Their expression levels are associated with tumor differentiation, invasion, and metastasis, and hold predictive value for the risk and prognosis of CRC patients.