Catalytic subunit of human telomerase reverse transcriptase is an independent predictor of survival in patients undergoing curative resection of hepatic colorectal metastases:: a Multicenter analysis
Catalytic subunit of human telomerase reverse transcriptase is an independent predictor of survival in patients undergoing curative resection of hepatic colorectal metastases:: a Multicenter analysis
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DOI：
10.1200/jco.2005.06.944
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发表时间：
2005-05-01
影响因子：
45.3
通讯作者：
Vauthey, JN
中科院分区：
文献类型：
--
作者：
Dômomt, J;Pawlik, TM;Vauthey, JN
目的探讨人端粒酶逆转录酶催化亚单位(HTERT)在预测肝结直肠转移瘤(CRM)术后生存中的作用。用标准的免疫组织化学技术分析CRM中hTERT核仁的表达。结果中位随访80个月，152例(75.6%)死亡，5年总生存率为30.7%。在单因素分析中，转移数目大于2个(P=.0005)、肝外疾病(P=.0054)、无病间隔<12个月(P=.006)、癌胚抗原水平>200 ng/mL(P=.0071)和hTERT核仁染色阳性(P<；.0001)与生存率下降有关。在多变量分析中，有三个因素独立预测生存：转移数目(相对风险[RR]=1.74；P=.0011)；无病间隔(RR=1.70；P=.0035)；hTERT核仁染色阳性(RR=2.03-1 P&t；.0001)。不存在或存在其中一种因素的患者的5年生存率为48%，而存在其中两种或三种因素的患者的五年生存率为15%(P<；0.0001)。结论hTERT核仁表达与肝切除后较差的生存有关。HTERT的表达与肝转移数目和无瘤间隔时间相结合，可以更准确地预测肝切除后的生存率。
Purpose To determine the role of the catalytic subunit of human telomerase reverse transcriptase (hTERT) in predicting survival after resection of hepatic colorectal metastases (CRM).Patients and Methods Two hundred one patients who underwent curative resection of hepatic CRM between 1990 and 2000 were identified from a multicenter database. The CRM were analyzed for hTERT nucleolar expression by standard immunohistochemical techniques. hTERT expression and known clinicopathologic factors of survival were examined.Results With a median follow-up of 80 months, 152 patients (75.6%) had died; the 5-year overall survival was 30.7%. On univariate analysis, number of metastases greater than two (P = .0005), extrahepatic disease (P = .0054), disease-free interval less than 12 months (P = .006), carcinoembryonic antigen level greater than 200 ng/mL (P = .0071), and positive hTERT nucleolar staining (P < .0001) were associated with decreased survival. On multivariate analysis, three factors independently predicted survival: number of metastases (relative risk [RR] = 1.74; P = .0011); disease-free interval (RR = 1.70; P = .0035); and positive hTERT nucleolar staining (RR = 2.03-1 P < .0001). Patients with none or one of these factors had a 5-year survival rate of 48%, whereas those with two or three of these factors had a 5-year survival of 15% (P < .0001).Conclusion hTERT nucleolar expression is associated with worse survival after resection of hepatic CRM. hTERT expression in conjunction with number of hepatic metastases and disease-free interval may permit more accurate prediction of survival after resection of hepatic CRM.