Iusco Domenico, Sarli Leopoldo, Bottarelli Lorena, Pizzi Silvia, Donadei Enrico, Caruso Giuseppe, D'Adda Tiziana, Roncoroni Luigi
Dipartimento di Scienze Chirurgiche, Sezione di Clinica Chirurgica Generale e Terapia Chirurgica, Università degli Studi di Parma.
Chir Ital. 2003 Nov-Dec;55(6):821-8.
The prediction of recurrence and the prognosis of colorectal cancer have always been related to the stage of the disease. Clinical pathological classifications are unable to predict the individual risk of recurrence and the prognosis which would also appear to be linked to additional factors, which have yet to be properly assessed, such as the genetic endowment of the tumour. In this study we assessed how microsatellite and chromosomal instability may help us to stratify two classes of risk of recurrence in patients at the same stage. From July 1996 to June 1999 we prospectively collected data on 112 patients (59 male, 53 female) affected by colorectal cancer and undergoing surgery with a radical intent. Biopsies of normal and tumor tissue were submitted to DNA extraction and amplification to evaluate the presence of chromosomal instability (loss of heterozygosity) and microsatellite instability. Analysis of the data revealed that loss of heterozygosity in the long arm of chromosome 18 is associated, in patients with stage III colorectal cancer, with a higher risk of recurrence and therefore with a worse prognosis. Microsatellite instability proved to be associated with a better prognosis even in cases of recurrence.
结直肠癌复发的预测和预后一直与疾病分期相关。临床病理分类无法预测个体的复发风险,而预后似乎还与其他尚未得到恰当评估的因素有关,比如肿瘤的遗传特性。在本研究中,我们评估了微卫星和染色体不稳定性如何有助于我们对处于相同分期的患者复发风险的两类情况进行分层。从1996年7月至1999年6月,我们前瞻性地收集了112例接受根治性手术的结直肠癌患者(59例男性,53例女性)的数据。对正常组织和肿瘤组织活检样本进行DNA提取和扩增,以评估染色体不稳定性(杂合性缺失)和微卫星不稳定性的存在情况。数据分析显示,在III期结直肠癌患者中,18号染色体长臂的杂合性缺失与较高的复发风险相关,因此预后较差。即使在复发病例中,微卫星不稳定性也被证明与较好的预后相关。