The cluster of differentiation 47 expression in rectal cancer and efficacy of neoadjuvant therapies

Aim: To investigate the relationship between CD47 expression levels, clinicopathological features, and survival in rectal cancer. Material and Methods: It was designed as a retrospective case-control study. CD47 was analyzed in tumor tissue from patients with stage II and III rectal cancer who received neoadjuvant treatment. Patients were classified as negative, low, or high based on the CD47 H score. The pathological features of the disease, responses to neoadjuvant treatment, and overall survival were examined in relation to CD47. Results: There were CD47 negative (n = 19, 31%), low (n = 18, 30%), and high (n = 24, 39%) patients. CD47 positivity was more common in female patients (p = 0.023). No significant differences were observed between the groups regarding relapse (p = 0.822), tumor location (p = 0.379), T stage (p = 0.360), preoperative lymph node status (p = 0.332), tumor grade (p = 0.801), perineural invasion (PNI) (p = 0.160), lymphovascular invasion (LVI) (p = 0.294), budding (p = 0.043), CEA level (p = 0.413), neoadjuvant treatment type (p = 0.650), T downstaging (p = 8.39), N downstaging (p = 0.530), surgery type (p = 0.717), pathological complete response (p = 0.747), tumor regression score ( p= 0.836), positive surgical margin (p = 0.309), or (p = 0.028). The 5-year OS was 88% for patients with negative CD47, 74% for those with low CD47, and 57% for high CD47 (p=0.035). Conclusion: Pretreatment CD47 score is important in terms of survival and prognosis in rectal cancer. The function of CD47 is more complex and needs to be further studied.