{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T11:06:05Z","timestamp":1784718365274,"version":"3.55.0"},"reference-count":57,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int. J. Mol. Sci.","IJMS"],"abstract":"<jats:p>The prediction of the therapeutic response and of the patient outcome following neoadjuvant chemoradiotherapy (nCRT) in rectal cancer (RC) is still a challenging issue. The role of Annexin 1 (ANXA1) in the modulation of the tumor cells\u2019 growth and metastasis has been recently demonstrated, being associated with aggressive pathological features and poor outcome in specific malignancies. The present study aimed to evaluate the association between ANXA1 expression, survival, and clinicopathological parameters of a group of patients diagnosed with ypT3 locally advanced rectal cancer (LARC) following nCRT. The study group consisted of 60 LARC patients with ypT3 tumor stage showing a tumor fragmentation pattern following nCRT. The clinicopathological characteristics and survival parameters in relation to ANXA1 immunohistochemistry characteristics and its scoring were evaluated. ANXA1 expression in tumor cells showed variable intense luminal membrane or combined luminal membrane and cytoplasmic location, excepting three negative cases. The statistical analysis demonstrated a significant association between high ANXA1 expression and ypN category (p &lt; 0.001), perineural invasion (PnI) (p = 0.002), and lymphovascular invasion (LVI) (p = 0.021). Survival analysis showed that high ANXA1 expression is associated with a reduced overall survival (OS) (p = 0.001), while univariate Cox regression confirmed ANXA1 value as an independent predictor of prognosis (H = 5.922, p = 0.004). Our results support ANXA1 value as a potential biomarker of aggressive tumor behavior and poor prognosis in ypT3 LARC patients, with potential implications in diagnosis stratification, opening the prospective to apply precision oncology strategies. However, further studies are required to certify ANXA1 diagnostic and therapeutic relevance in RC patients.<\/jats:p>","DOI":"10.3390\/ijms27146512","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T10:48:28Z","timestamp":1784717308000},"page":"6512","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic and Diagnostic Significance of Annexin A1 in ypT3 Locally Advanced Rectal Cancer Patients"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2400-6636","authenticated-orcid":false,"given":"Diana Lavinia","family":"Pricope","sequence":"first","affiliation":[{"name":"Department of Morphofunctional Sciences I, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6641-5135","authenticated-orcid":false,"given":"Adriana","family":"Grigora\u0219","sequence":"additional","affiliation":[{"name":"Department of Morphofunctional Sciences I, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania"},{"name":"Department of Histopathology, Institute of Legal Medicine, 700455 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel Mihail","family":"Dimofte","sequence":"additional","affiliation":[{"name":"Surgical Department, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania"},{"name":"2nd Clinic of Surgical Oncology, Regional Institute of Oncology, 700483 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8228-104X","authenticated-orcid":false,"given":"Cornelia","family":"Amalinei","sequence":"additional","affiliation":[{"name":"Department of Morphofunctional Sciences I, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania"},{"name":"Department of Histopathology, Institute of Legal Medicine, 700455 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1136\/gutjnl-2022-327736","article-title":"Global burden of colorectal cancer in 2020 and 2040: Incidence and mortality estimates from GLOBOCAN","volume":"72","author":"Morgan","year":"2023","journal-title":"Gut"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Wu, S., Zhang, Y., Lin, Z., and Wei, M. (2025). Global burden of colorectal cancer in 2022 and projections to 2050: Incidence and mortality estimates from GLOBOCAN. 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