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Transcobalamin (TCN1) is a vitamin B12 (cobalamin)-binding protein that regulates cobalamin homeostasis. Recent studies and bioinformatic analyses have found that  TCN1  is highly expressed in cancer tissues and is associated with tumour aggressiveness and poor prognosis. The present study aimed to detect  TCN1  as a novel biomarker for prognosis and chemosensitivity of colon cancer. Next-generation sequencing showed that  TCN1  was one of several upregulated mRNAs in colon cancer, which was verified by further bioinformatics analyses. Western blotting (n = 9) and quantitative real time polymerase chain reaction (qRT-PCR, n = 30) revealed that  TCN1  was highly expressed in colon cancer tissues at both the protein and mRNA level. A total of 194 cases of colon cancer were examined by immunohistochemistry and revealed that TCN1 expression level was related to advanced stages ( P  < 0.005). Kaplan–Meier analysis verified that patients with lower TCN1 expression usually had longer overall survival ( P  = 0.008). In addition, TCN1 was highly expressed in pulmonary metastatic tumour tissues (n = 37,  P  = 0.025) and exhibited higher levels in right-sided colon cancer than in left-sided colon cancer ( P  = 0.029). TCN1 expression in specimens that had received neoadjuvant chemotherapy decreased compared with that in colonoscopy biopsy tissues (n = 42,  P  = 0.009). Further bioinformatics analyses verified that apoptosis pathways might have a role in high  TCN1  expression. All the studies revealed that  TCN1  expression in colon cancer was significantly associated with malignant biological behaviour. Therefore, TCN1 could be used as a novel biomarker for colon cancer aggressiveness and prognosis and might also be a potential biomarker for predicting neoadjuvant chemosensitivity.

High expression of TCN1 is a negative prognostic biomarker and can predict neoadjuvant chemosensitivity of colon cancer