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WRAP53 is an independent prognostic factor in rectal cancer- a study of Swedish clinical trial of preoperative radiotherapy in rectal cancer patients

Hong Zhang1, Da-Wei Wang12, Gunnar Adell3 and Xiao-Feng Sun4*

Author Affiliations

1 Division of Biomedicine, The Systems Biology Research Center, University of Skövde, Skövde, Sweden

2 Department of Stomatology, The Third Hospital of Hebei Medical University, Hebei, China

3 Department of Oncology, Karolinska University Hospital, Karolinska, Sweden

4 Division of Oncology, Department of Clinical and Experimental Medicine, Faculty of Heath Science, Linköping University, S-581 85, Linköping, Sweden

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BMC Cancer 2012, 12:294  doi:10.1186/1471-2407-12-294

Published: 17 July 2012



Expression of WRAP53 protein has oncogenic properties and it is up regulated in several types of tumors.


We examined expression of WRAP53 protein in rectal cancers and analyzed its relationship to the response to preoperative radiotherapy and patient survival. The WRAP53 protein was examined by immunohistochemistry in normal mucosa, primary tumors and lymph node metastases from 143 rectal cancer patients participated in a Swedish clinical trial of preoperative radiotherapy.


Frequency of WRAP53 protein expression was increased in primary rectal cancer compared to the normal mucosa (p < 0.05). In non-radiotherapy group positive WRAP53 in primary tumors (p = 0.03, RR, 3.73, 95% CI, 1.13-11.89) or metastases (p = 0.01, RR, 4.11, 95% CI, 1.25-13.14), was associated with poor prognosis independently of stages and differentiations. In radiotherapy group, positive WRAP53 in the metastasis correlated with better survival (p = 0.04). An interaction analysis showed that the correlations of WRAP53 with the prognostic significance with and without radiotherapy in the metastasis differed (p = 0.01). In the radiotherapy group, expression of WRAP53 in metastases gave a better outcome (p = 0.02, RR, 0.32, 95% CI, 0.13-0.84), and an interaction analysis showed significance between the two groups (p = 0.01).


WRAP53 may be a new biomarker used to predict prognosis and to select suitable patients for preoperative radiotherapy.

WRAP53; Radiotherapy; Prognosis; Rectal cancer