Department of Pathology, CHA University College of Medicine, Seongnam, Korea.
Ann Surg Oncol. 2011 Mar;18(3):711-9. doi: 10.1245/s10434-010-1338-z. Epub 2010 Sep 24.
With the recent development of molecular markers, it has become possible to characterize colorectal carcinomas beyond clinical and histologic aspects. When considered together with tumor stage, molecular markers will allow us further insight into individual tumor biologies and prognoses.
To investigate the expression and prognostic implications of the molecular markers, p53, bcl-2, Rb, hMLH1, hMSH2, β-catenin, E-cadherin, and MUC-2.
We analyzed the clinical, histologic, and molecular factors for 229 patients with colorectal carcinoma of stage II and III and compared their prognoses. We used tissue microarrays to analyze the expressions of molecular markers and to assess their correlations with prognosis. Semiquantitative expressions of molecular markers and clinicopathologic parameters were analyzed with respect to prognosis.
Among the clinicopathologic parameters, left-sided location, age older than 70 years, higher preoperative serum carcinoembryonic antigen (CEA) level (≤ 5 ng/mL), irregular growth pattern, and perineural invasion were significantly related to poor prognosis in stage II and III patients. For molecular factors, loss of expression of E-cadherin and MUC-2 showed significant correlation with poor overall survival in both cancer stages. Multivariate analysis showed that higher TNM stage, higher preoperative serum CEA level (≤ 5 ng/mL), perineural tumor cell invasion, and loss of E-cadherin and MUC-2 expressions were independently correlated with poor overall survival.
Our results indicated that of the analyzed molecular markers, MUC-2 and E-cadherin might be useful in predicting prognosis and planning for adjuvant therapy in patients with stage II and III colorectal carcinomas.
随着分子标志物的最新发展，超越临床和组织学方面来描述结直肠癌已成为可能。当与肿瘤分期一起考虑时，分子标志物将使我们能够进一步深入了解个体肿瘤的生物学和预后。
研究分子标志物 p53、bcl-2、Rb、hMLH1、hMSH2、β-连环蛋白、E-钙黏蛋白和 MUC-2 的表达及其预后意义。
我们分析了 229 例 II 期和 III 期结直肠癌患者的临床、组织学和分子因素，并比较了他们的预后。我们使用组织微阵列分析了分子标志物的表达，并评估了它们与预后的相关性。用半定量方法分析了分子标志物和临床病理参数与预后的关系。
在临床病理参数中，左侧位置、年龄大于 70 岁、术前血清癌胚抗原（CEA）水平较高（≤5ng/mL）、不规则生长模式和神经周围侵犯与 II 期和 III 期患者的不良预后显著相关。对于分子因素，E-钙黏蛋白和 MUC-2 的表达缺失与两个肿瘤分期的总生存均显著相关。多因素分析显示，较高的 TNM 分期、术前血清 CEA 水平较高（≤5ng/mL）、神经周围肿瘤细胞侵犯以及 E-钙黏蛋白和 MUC-2 的缺失表达与总生存不良独立相关。
我们的结果表明，在分析的分子标志物中，MUC-2 和 E-钙黏蛋白可能有助于预测 II 期和 III 期结直肠癌患者的预后并为辅助治疗提供指导。
