Molecular markers are predictors of recurrence and survival in patients with Dukes B and Dukes C colorectal adenocarcinoma
Molecular markers are predictors of recurrence and survival in patients with Dukes B and Dukes C colorectal adenocarcinoma
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DOI：
10.1007/bf02234324
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发表时间：
2001-04-01
影响因子：
3.9
通讯作者：
Trivedi, TI
中科院分区：
文献类型：
--
作者：
Bhatavdekar, JM;Patel, DD;Trivedi, TI
目的：研究各种分子标记物（如 CEA、Cyclin D1、Bcl-2、c-Myc、p53、p21(ras)、Ki-67、CD44、因子 VIII 相关抗原、细胞角蛋白-19、腺瘤抗原和催乳素）对 Dukes B 和 Dukes C 结直肠腺癌患者的预后价值。方法：这些分子标记通过免疫组织化学方法定位于结直肠非恶性（n = 36）和恶性（n = 98）疾病。使用SPSS软件程序对数据进行统计分析。对结直肠癌患者进行为期五年的随访或在该期间内死亡。结果：癌胚抗原、Cyclin D1、Bcl-2、CD44、细胞角蛋白-19和催乳素在恶性疾病中表达显着升高（P < 0.05），而p21（ras）在非恶性疾病中表达显着升高（P = 0.002）。除 Dukes 分期外，多变量分析表明表达 CD44 和 cytokeratin-19 的患者的无复发生存率显着降低 (P < 0.005)。同样，除了 Dukes 分期外，多变量分析表明表达 CD44、细胞角蛋白-19 和催乳素的患者总体生存率显着较差 (P < 0.01)。在Dukes B病患者中，仅细胞角蛋白-19和CD44表达具有统计学意义（P < 0.05），而在Dukes C病患者中，CD44、p21（ras）和c-Myc表达具有统计学意义（P < 0.018）。此外，还使用 CD44 和 cytokeratin-19 进行了与治疗相关的多变量分析。结论：除了Dukes分期外，对所有研究的分子标记物的多变量分析表明，表达CD44和细胞角蛋白-19的患者的无复发率显着降低且总生存率较差。此外，与仅接受手术治疗的患者相比，在手术后接受辅助化疗时，表达这两种标志物（CD44 和细胞角蛋白-19）的患者的复发相对风险最低。因此，在结直肠癌患者中，CD44 和细胞角蛋白-19 的免疫组织化学定位可能被纳入预后因素的一部分。
PURPOSE: The goal was to investigate the prognostic value of various molecular markers like CEA, Cyclin D1, Bcl-2, c-Myc, p53, p21(ras), Ki-67, CD44, Factor VIII-related antigen, cytokeratin-19, adenoma antigen, and prolactin in patients with Dukes B and Dukes C colorectal adenocarcinoma. METHODS: These molecular markers were localized immunohistochemically in nonmalignant (n = 36) and malignant (n = 98) diseases of the colorectum. Data were analyzed statistically using the SPSS software program. The patients with colorectal cancer were followed for a period of five years or their death a within that period. RESULTS: The expression of carcinoembryonic antigen, Cyclin D1, Bcl-2, CD44, cytokeratin-19 and prolactin was significantly higher in malignant diseases (P < 0.05), whereas, p21(ras) was found to be significantly higher in nonmalignant diseases (P = 0.002) as compared with their respective counterparts. Besides Dukes stage, multivariate analysis indicated a significantly reduced relapse-free survival in patients expressing CD44 and cytokeratin-19 (P < 0.005). Similarly, besides Dukes stage, multivariate analysis indicated a significantly poor overall survival in patients expressing CD44, cytokeratin-19 and prolactin (P < 0.01). In patients with Dukes B disease, only cytokeratin-19 and CD44 expression attained statistical significance (P < 0.05), whereas in. patients with Dukes C disease, CD44, p21(ras) and c-Myc expression attained statistical significance (P < 0.018). Also, a multivariate analysis in relation to treatment given was performed using CD44 and cytokeratin-19. CONCLUSION: Besides Dukes stage, multivariate analysis of all the studied molecular markers showed that patients expressing CD44 and cytokeratin-19 had a significantly reduced relapse-free and poor overall survival. Moreover, patients expressing both these markers (CD44 and cytokeratin-19) had the lowest significant relative risk for developing recurrence than patients with both markers negative when treated with surgery followed by adjuvant chemotherapy as compared with patients treated with surgery alone. Thus, in patients with colorectal cancer, immunohistochemical localization of CD44 and cytokeratin-19 may be included as a part of prognostic factors.