Combined Phenotype of 4 Markers Improves Prognostic Value of Patients With Colon Cancer
Combined Phenotype of 4 Markers Improves Prognostic Value of Patients With Colon Cancer
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DOI：
10.1097/maj.0b013e31822cb4cd
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发表时间：
2012-04-01
影响因子：
3.1
通讯作者：
Shou, Chengchao
中科院分区：
文献类型：
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作者：
Liu, Caiyun;Qu, Like;Shou, Chengchao
介绍：代表肿瘤生物学不同方面的多种生物标志物的组合将具有更好的预后价值。本研究旨在通过联合分析突触核蛋白-γ（SNCG）、piwi的人类同源物（Hiwi）、再生肝磷酸酶-3（PRL-3）、逮捕缺陷蛋白1、同源物A（ARD 1）和临床病理特征来确定结肠腺癌的预后亚组225例结肠腺癌标本。研究方法：对225例结肠腺癌患者完整的临床病理资料和长达10年的随访进行了4种肿瘤标志物的免疫组化。免疫组化表达模式进行了检查，单独和多标记物组合。进行单变量和多变量分析，以确定不良结局的独立预测标志物。结果如下：肿瘤标志物检测阳性率SNCG为32.0%（62/225），SNCG/Hiwi/PRL-3/ARD 1联合检测阳性率为76.9%（173/225），检测准确率SNCG为61.9%（252/407）; SNCG/Hiwi/PRL-3/ARD 1联合治疗组为82.6%（336/407）]增加，SNCG/Hiwi/PRL-3/ARD 1联合治疗组的增加值（P < 0.001;风险比（HR）为3.2）。（P = 0.004; HR，3.2）导致无淋巴结转移（LN-）和SNCG的患者预后不良（P < 0.001; HR，2.5）对于淋巴结转移（LN+）患者具有独立的不良预后价值。结论：多表型联合检测可提高肿瘤检出率、诊断准确性及预后价值。此外，可以通过评估LN-癌症中的Hiwi水平和LN+癌症中的SNCG水平来鉴定更具侵袭性的肿瘤的亚组。
Introduction: Combination of multiple biomarkers representing distinct aspects of tumor biology will have a better prognostic value. This study was to identify prognostic subgroups of colon adenocarcinoma by combined analysis of synuclein-gamma (SNCG), a human homologue of piwi (Hiwi), phosphatase of regenerating liver-3 (PRL-3), arrest-defective protein 1, homolog A (ARD1) and clinicopathologic features in 225 colon adenocarcinoma specimens. Methods: Immunohistochemistry for 4 tumor markers was performed in whole tissue sections from 225 colon adenocarcinoma patients with complete clinicopathologic data and up to 10-year follow-up. The immunohistochemical expression patterns were examined individually and in multimarker combinations. Univariate and multivariate analyses were performed to identify independent predictive markers of poor outcome. Results: With the tumor marker positive rate [32.0% (62/225) for SNCG; 76.9% (173/225) for combined SNCG/Hiwi/PRL-3/ARD1] and the detecting accuracy [61.9% (252/407) for SNCG; 82.6% (336/407) for combined SNCG/Hiwi/PRL-3/ARD1] increasing, incremental value of combined SNCG/Hiwi/PRL-3/ARD1 (P < 0.001; hazard ratios (HR), 3.2) to poor outcome was found. Stratified by lymph node, Hiwi alone (P = 0.004; HR, 3.2) led to poor outcome in patients without lymph node metastasis (LN-), and SNCG (P < 0.001; HR, 2.5) had independently poor prognostic value for patients with lymph node metastasis (LN+). Conclusions: Multimarker phenotypes improved tumor positive rate, detecting accuracy and prognostic value. In addition, a subgroup of more aggressive tumors can be identified by evaluating Hiwi level in LN- cancer, and SNCG level in LN+ cancer.