Perineural invasion (PNI) is a prominent characteristic of multiple solid tumors and indicates poor prognosis. Previous data concerning the impact of PNI on prognosis of patients with colorectal cancer (CRC) are conflicting, and little is known about risk factors of PNI. The aim of our study was to reveal the clinical implication of PNI on survival outcome and identify risk factors for the poor prognosis in patients with CRC. We retrospectively reviewed 627 patients who were diagnosed with CRC and underwent curative surgical resection. The differences in several clinicopathologic characteristics were compared between PNI positive and PNI negative groups. Multivariate logistic regression analysis was performed to identify predictors of CRC with PNI. Five-year overall survival (OS) and disease-free survival (DFS) were calculated using the Kaplan–Meier method, and the difference in survival rate was assessed by the log-rank test. The variables that had prognostic potential, as indicated by univariate analyses, were subjected to multivariate analyses with the Cox proportional hazards regression model. PNIs were identified in 79 patients (12.6%). Age, T classification, N classification, M classification, UICC classification, and lymphovascular invasion were significantly associated with PNI. Multivariate logistic regression analysis demonstrated that only lymphovascular invasion was a predictor of PNI. Pathologic evidence of PNI was not associated with survival outcome (the 5-year OS [P = .560] and DFS [P = .083]). Cox proportional hazards regression model revealed that age and N2/3 classification were independent prognostic factors for poorer OS and DFS. M1 stage (95% confidence interval [CI] = 0.228–0.585, P = .000), III/IV stage (95% CI = 0.335–0.920, P = .022), and number of sampled lymph nodes (95% CI = 0.951–0.987, P = .001) were independently prognostic for poorer OS, while history of other malignancy (95% CI = 1.133–2.813, P = .012) was identified as an independent prognostic factor for poorer DFS. Our study indicates that PNI is not an independent poor prognostic factor in patients with CRC and those patients with PNI may not benefit from postoperative adjuvant chemotherapy.

Gastric cancer (GC) is one of the most common malignancies in digestive system. Accumulating evidence reveals the critical role of long noncoding RNAs (lncRNAs) in GC development. The study aimed to explore the functions and mechanism of lncRNA actin alpha 2, smooth muscle antisense RNA 1 (ACTA2-AS1) in GC. Reverse transcription-quantitative polymerase chain reaction analyses and subcellular fractionation assays showed that ACTA2-AS1 was lowly expressed in GC cells and was mainly distributed in the cytoplasm. Overexpressed ACTA2-AS1 inhibited GC cell viability, proliferation, migration, invasion, and epithelial-mesenchymal transition process, as suggested by cell counting kit-8 assays, colony formation assays, wound healing assays, Transwell assays and Western blot analyses. Mechanistically, ACTA2-AS1 served as a competing endogenous RNA (ceRNA) to bind with miR-378a-3p and thereby, antagonized the inhibitory effect of miR-378a-3p on the expression of messenger RNA phosphatidylinositol specific phospholipase C X domain containing 2 (PLCXD2). The binding capacity between miR-378a-3p and ACTA2-AS1 (or PLCXD2) was detected by RNA pulldown assays, luciferase reporter assays and RNA immunoprecipitation assays. Moreover, PLCXD2 knockdown rescued the inhibitory effect of ACTA2-AS1 overexpression on malignant behaviors of GC cells. Overall, ACTA2-AS1 inhibits malignant phenotypes of GC cells by acting as a ceRNA to target miR-378a-3p/PLCXD2 axis.