Prognostic value of thymidylate synthase, Ki-67, and p53 in patients with Dukes' B and C colon cancer:: A national cancer institute-national surgical adjuvant breast and bowel project collaborative study
Prognostic value of thymidylate synthase, Ki-67, and p53 in patients with Dukes' B and C colon cancer:: A national cancer institute-national surgical adjuvant breast and bowel project collaborative study
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DOI：
10.1200/jco.2003.05.044
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发表时间：
2003-01-15
影响因子：
45.3
通讯作者：
Wieand, HS
中科院分区：
文献类型：
--
作者：
Allegra, CJ;Paik, S;Wieand, HS
目的：探讨胸苷酸合成酶（TS）、Ki-67和p53在11期和III期结肠癌患者预后中的价值。患者和方法：我们回顾性分析706例Dukes' B（291例）或Dukes' C（415例）结肠癌患者的TS、Ki-67和p53的预后价值，这些患者在国家手术辅助乳房和肠道计划（NSABP）方案C01 -C04中接受单独手术（275例）或手术加氟尿嘧啶(FU)-亚叶酸素化疗（431例）。使用免疫组织化学技术检测所有三种标记物。结果：通过5年的随访资料，我们的回顾性分析显示，RFS和OS的TS强度（无复发生存期[RFS]：风险比[RR] = 1.46, P = 0.01；总生存期[OS]: RR = 1.54, P = 0.002）、Ki-67 （RFS: RR = 0.76, P = 0.05; OS: RR = 0.62, P = 0.001）和p53 （RFS: RR = 1.49, P = 0.01; OS: RR = 1.21, P = 0.18）之间存在相关性。高TS强度水平和阳性p53染色与较差的预后相关。与那些肿瘤中阳性细胞相对较少的患者相比，含有高比例ki -67阳性细胞的肿瘤具有更好的预后。没有发现任何标记物与治疗的相互作用。结论：本回顾性研究显示TS、Ki-67和p53染色对Dukes' B和C结肠癌患者的预后均有重要价值。然而，没有一种标记物可以用来清楚地辨别出哪些个体可以从辅助化疗的使用中获得或多或少的益处。(C) 2003年由美国临床肿瘤学会出版。
Purpose: To define the value of thymidylate synthase (TS), Ki-67, and p53 as prognostic markers in patients with stage 11 and III colon carcinoma.Patients and Methods: We retrospectively analyzed the prognostic value of TS, Ki-67, and p53 in 706 patients with Dukes' B (291 patients) or Dukes' C (415 patients) colon carcinoma who were treated with either surgery alone (275 patients) or surgery plus fluorouracil (FU)-leucovorin chemotherapy (431 patients) in National Surgical Adjuvant Breast and Bowel Project (NSABP) protocols C01 -C04. All three markers were assayed using immunohistochemical techniques.Results: Using 5 years of follow-up data, our retrospective analysis demonstrated an association between TS intensity (relapse-free survival [RFS]: risk ratio [RR] = 1.46, P = .01; overall survival [OS]: RR = 1.54, P = .002), Ki-67 (RFS: RR = 0.76, P = .05; OS: RR = 0.62, P = .001), and p53 (RFS: RR = 1.49, P = .01; OS: RR = 1.21, P = .18) for RFS and OS. High TS intensity levels and positive p53 staining were associated with a worse outcome. Tumors containing a high percentage of Ki-67-positive cells enjoyed an improved outcome compared with those patients whose tumors contained relatively few positive cells. An interaction with treatment was not identified for any of the markers.Conclusion: This retrospective investigation demonstrated that TS, Ki-67, and p53 staining each had significant prognostic value for patients with Dukes' B and C colon carcinoma. However, none of the markers could be used to clearly discern groups of individuals who would be predicted to derive greater or lesser benefit from the use of adjuvant chemotherapy. (C) 2003 by American Society of Clinical Oncology.