Grizzle William E, Manne Upender, Weiss Heide L, Jhala Nirag, Talley Lynya
Department of Pathology, UAB Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL 35233-0007, USA.
Int J Cancer. 2002 Feb 1;97(4):403-9. doi: 10.1002/ijc.1617.
The gold standard for clinical outcome of most cancers has been the clinical and pathologic staging of the tumors after surgery. For colorectal cancer (CRC), nodal involvement at the time the primary tumor is resected has been the most reliable indicator of clinical outcome; however, recently, combinations of molecular markers have been reported to be equivalent to pathologic or clinical staging in predicting clinical outcome. In addition, molecular markers can be used in conjunction with clinical or pathologic staging to provide a stronger indicator of clinical outcome than staging alone. We propose that "molecular staging" be added to pathologic staging to aid in predicting clinical outcome and making therapeutic decisions for colorectal cancers, especially stage II and III CRCs. We have reported that the clinical usefulness of most molecular markers varies with the ethnic group of the patients and the anatomic location of CRCs; this complicates the evaluation of prognostic biomarkers and requires much larger numbers of cases to be evaluated. Nevertheless, nuclear accumulation of p53 (p53(nac)) and phenotypic expression of Bcl-2, MUC-1 and p27(kip-1) may be molecular markers approaching acceptance for use in molecular staging of specific subgroups of colorectal cancers.
大多数癌症临床结局的金标准一直是手术后肿瘤的临床和病理分期。对于结直肠癌（CRC），原发性肿瘤切除时的淋巴结受累情况一直是临床结局最可靠的指标；然而，最近有报道称，分子标志物组合在预测临床结局方面等同于病理或临床分期。此外，分子标志物可与临床或病理分期结合使用，以提供比单独分期更强的临床结局指标。我们建议将“分子分期”添加到病理分期中，以帮助预测结直肠癌，尤其是II期和III期CRC的临床结局并做出治疗决策。我们已经报道，大多数分子标志物的临床实用性因患者的种族群体和CRC的解剖位置而异；这使得预后生物标志物的评估变得复杂，并且需要评估大量病例。尽管如此，p53的核积累（p53(nac)）以及Bcl-2、MUC-1和p27(kip-1)的表型表达可能是接近被接受用于特定亚组结直肠癌分子分期的分子标志物。
