Mottolese M, Buglioli S, Piperno G, Sperduti I, Giannarelli D, D'Angelo C, Cosimelli M
Pathology Department, Regina Elena Cancer Institute, Rome, Italy.
J Exp Clin Cancer Res. 2003 Dec;22(4 Suppl):163-6.
About 40% of patients bearing a colorectal carcinoma will develop local or distant tumor recurrences. Integrated analyses of biopathological markers, predictive of tumor aggressiveness, may offer a more rational approach to adjuvant therapy planning. To this end we analyzed the correlation between p53 accumulation, bcl-2 expression with cell proliferation, DNA ploidy, and conventional histological parameters, by testing the prognostic significance of these variables in a series of 214 patients bearing a colorectal carcinoma. When these parameters were examined in the univariate analysis, significantly shorter disease free and overall survival were observed in patients bearing p53+ and bcl-2- tumors. In the multivariate analysis p53 accumulation and bcl-2 expression emerged as independent predictors respectively of worse and better clinical outcome also in Dukes' B stage identifying patients at higher risk to develop liver metastases.. These results indicate that in colorectal adenocarcinomas a biological profile, based on the combined evaluation of p53 and bcl-2, can be useful in identifying high risk patients to be enrolled in an adjuvant setting mainly in early stage of the disease.
约40%的结直肠癌患者会出现局部或远处肿瘤复发。对预测肿瘤侵袭性的生物病理学标志物进行综合分析，可能为辅助治疗方案的制定提供更合理的方法。为此，我们通过检测一系列214例结直肠癌患者中这些变量的预后意义，分析了p53蓄积、bcl-2表达与细胞增殖、DNA倍体及传统组织学参数之间的相关性。在单因素分析中检查这些参数时，发现携带p53阳性和bcl-2阴性肿瘤的患者无病生存期和总生存期显著缩短。在多因素分析中，p53蓄积和bcl-2表达分别成为临床结局较差和较好的独立预测因素，在Dukes B期患者中也能识别出发生肝转移风险较高的患者。这些结果表明，在结直肠癌中，基于p53和bcl-2联合评估的生物学特征，可用于识别主要在疾病早期需接受辅助治疗的高危患者。
