TUMOR ANGIOGENESIS AS A PREDICTOR OF RECURRENCE AND SURVIVAL IN PATIENTS WITH NODE-NEGATIVE COLON-CANCER
TUMOR ANGIOGENESIS AS A PREDICTOR OF RECURRENCE AND SURVIVAL IN PATIENTS WITH NODE-NEGATIVE COLON-CANCER
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DOI：
10.1097/00000658-199512000-00002
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发表时间：
1995-12-01
影响因子：
9
通讯作者：
RUBIN, DB
中科院分区：
文献类型：
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作者：
FRANK, RE;SACLARIDES, TJ;RUBIN, DB
作者的目的是定量评估淋巴结阴性结肠癌的血管生成或新生血管，并确定血管生成增加与高复发率和低生存率之间的关系。新生血管通过促进营养和代谢物的交换促进肿瘤的快速生长。最近对乳腺癌和非小细胞肺癌的研究表明，低血管生成活性降低了复发和转移的风险。虽然辅助治疗对淋巴结阳性结肠癌患者有益，但对淋巴结阴性病变患者没有这种益处。然而，高达30%的后一组患者会复发。我们试图确定一组复发风险高的结阴性结肠癌患者，他们可能从这种治疗中受益。方法对105例结阴性结肠癌患者进行内皮细胞因子viii相关抗原免疫染色。在100倍放大率下，对三个显微镜视野内的血管进行计数，计算平均值，并给出血管生成评分。在对每张幻灯片进行全面调查后，分配主观血管生成等级（1-4）。然后对癌症复发和患者生存进行评分和分级。结果患者平均年龄71岁（范围41 ~ 90岁），肿瘤平均大小516 cm（范围2 ~ 12 cm）。平均随访6.5年；平均血管生成评分27.9（范围4-50）；平均评分2.0（范围1-4）。存活5年的患者血管生成评分明显低于未存活患者（22.8比43.2,p = 0.0004）。每增加10支血管，死亡风险增加2.0倍，复发风险增加2.7倍。存活5年的概率估计为：P(survival)=e(2.6290- 0.0976 . as)/1+e（2.6290-0.976. as）。复发率的估计公式为：P（复发率）=e(-3.5527+.08556. a.s.)/1+e（-3.5527+.08556. a.s.）结论结肠癌血管生成是肿瘤行为的重要预测指标，可以识别复发和早期死亡风险较高的患者。
Objective The authors' objective was to quantitatively assess angiogenesis or neovascularity within node-negative colon cancers and to determine ii increased angiogenesis correlated with higher recurrence and lower survival rates.Summary Background Data Neovascularization promotes rapid tumor growth by facilitating nutrient and metabolite exchange. Recent work with breast and nonsmall cell lung cancers has shown that low angiogenic activity imparts a lower risk of recurrence and metastasis. Although adjuvant therapy is beneficial for patients with node-positive colon cancers, no such benefit has been demonstrated for patients with node-negative lesions. Nevertheless, up to 30% of this latter group will experience recurrence. We sought to identify a subset of patients with node-negative colon cancers at high risk for recurrence who might benefit from such therapy.Methods One hundred five node-negative colon cancers were immunostained for endothelial cell factor VIII-related antigen. Blood vessels within three microscopic fields at 100X magnification were counted, the mean calculated, and an angiogenesis score assigned. A subjective angiogenesis grade (1-4) was assigned after each slide was surveyed in its entirety. Score and grade were then assessed with respect to cancer recurrence and patient survival.Results Mean patient age was 71 years (range, 41-90 years) and mean tumor size, 516 cm (range, 2-12 cm). Mean follow-up was 6.5 years; mean angiogenesis score, 27.9 (range, 4-50); and mean grade, 2.0 (range, 1-4). Patients living 5 years had significantly lower angiogenesis scores than did nonsurvivors (22.8 vs. 43.2, p = 0.0004). Each 10-vessel increase in score imparted a 2.0-fold greater hazard of death and a 2.7-fold greater hazard of recurrence. The probability of surviving 5 years is estimated by:P(survival)=e(2.6290-.0976.AS.)/1+e(2.6290-0.976.AS).and the probability of recurrence is estimated by:P(recurrence)=e(-3.5527+.08556.A.S.)/1+e(-3.5527+.08556.A.S.)Conclusions Angiogenesis within colon cancer is an important predictor of tumor behavior and may identify patients at higher risk for recurrence and early death.