Tumor necrosis is a new promising prognostic factor in colorectal cancer
Tumor necrosis is a new promising prognostic factor in colorectal cancer
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DOI：
10.1016/j.humpath.2010.04.018
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发表时间：
2010-12-01
期刊：
影响因子：
3.3
通讯作者：
Langner, Cord
中科院分区：
文献类型：
--
作者：
Pollheimer, Marion J.;Kornprat, Peter;Langner, Cord
结直肠癌肿瘤坏死的预后意义尚不清楚 我们的研究旨在分析肿瘤坏死相对于无进展生存和癌症特异性生存的预后价值，并将研究结果与参与控制癌细胞死亡的蛋白质（例如 p53 和 bcl-2）的表达联系起来。对总共 381 例结直肠癌标本进行了回顾性重新评估。对肿瘤坏死的程度进行了半定量评估，并记录为缺如、局灶性坏死。 (= 30%) 通过免疫组织化学方法评估 p53 和 bcl-2 的表达，并记录为阳性（使用 10% 的截止值）或阴性 此外，使用针对 hMLH1、hMSH2 和 hMSH6 的抗体通过免疫组织化学评估错配修复蛋白状态 在 365 例 (96%) 病例中观察到肿瘤坏死，其中 180 例 (47%) 肿瘤显示局灶性坏死，分别有 119 例（31%）中度坏死和 66 例（17%）广泛坏死 坏死程度与高 T 分类（P < 001）、高 N 分类（P = 005）、高国际抗癌联盟分期（P < 001）、肿瘤分化差（P < 001）、大肿瘤尺寸（P < 001）和血管侵犯（P = 01）显着相关。观察到表达 p53、bcl-2 和错配修复蛋白状态的坏死 肿瘤坏死被证明是无进展生存和癌症特异性生存的独立预后变量 总之，肿瘤坏死对结直肠癌患者的预后有显着影响 在苏木精和伊红染色切片中很容易评估其存在，因此应在病理报告中常规评论 (C) 2010 Elsevier Inc 保留所有权利
The prognostic significance of tumor necrosis in colorectal cancer is unclear Our study aimed to analyze the prognostic value of tumor necrosis with respect to progression-free and cancer-specific survival and to relate findings to expression of proteins Involved in the control of cancer cell death, such as p53 and bcl-2 A total of 381 colorectal cancer specimens were retrospectively reevaluated The extent of tumor necrosis was semiquantitatively assessed and recorded as either absent, focal (= 30%) Expression of p53 and bcl-2 was assessed immunohistochemically and recorded as either positive (using a cutoff value of 10%) or negative In addition, mismatch repair protein status was assessed by immunohistochemistry using antibodies directed against hMLH1, hMSH2, and hMSH6 Tumor necrosis was observed in 365 (96%) cases, with 180 (47%) tumors showing focal necrosis, 119 (31%) moderate necrosis, and 66 (17%) extensive necrosis, respectively Extent of necrosis was significantly associated with high T classification (P < 001), high N classification (P = 005), high International Union Against Cancer stage (P < 001), poor tumor differentiation (P < 001), large tumor size (P < 001), and blood vessel invasion (P = 01) No association of tumor necrosis with expression of p53, bcl-2, and mismatch repair protein status was observed Tumor necrosis proved to be an independent prognostic variable with respect to progression-free and cancer-specific survival In conclusion, tumor necrosis showed significant impact on prognosis of colorectal cancer patients Its presence is readily assessable in hematoxylin and eosin stained sections and should therefore routinely be commented upon in the pathology report (C) 2010 Elsevier Inc All rights reserved