Department of Internal Medicine II: Oncology/Haematology, University Cancer Center Hamburg, University Medical Center Hamburg Eppendorf, Martinistr, Germany.
Eur J Cancer. 2011 May;47(7):1080-5. doi: 10.1016/j.ejca.2010.11.015. Epub 2011 Jan 8.
Although survival rates of colon cancer patients diagnosed at an early stage (T1-2N0M0; Dukes A) vary considerably according to the studies cited, several studies indicate development of distant metastases already occurring in a considerable percentage of these patients leading to the death of the patients. This particular high risk group cannot be identified properly as no marker exists to identify these patients. As the Wnt/Win pathway plays a crucial role in metastasis formation in colorectal carcinoma, we analysed whether the transcription factor brachyury critically involved in this pathway may predict metastasis formation in these patients. The expression of brachyury-homologous (T) was immunohistochemically analysed in 748 patients and the data were correlated with classical and newer prognostic markers in colorectal cancer. Early stages colorectal cancer patients (T1-2N0M0, Dukes A) showed a significantly decreased survival when brachyury was expressed in the tumour tissue while no correlation was observed in later tumour stages. Hence a subset of colorectal cancers exists in which the ability to metastasise is already present at early stages of tumour growth and this high risk group can now be detected by immunohistochemistry.
尽管根据引用的研究，早期诊断（T1-2N0M0；Dukes A）的结肠癌患者的生存率差异很大，但有几项研究表明，这些患者中已经有相当比例的患者发生了远处转移，导致患者死亡。由于没有标记物可以识别这些患者，因此无法正确识别这个特定的高风险群体。由于 Wnt/Win 通路在结直肠癌的转移形成中起着至关重要的作用，我们分析了转录因子 brachyury 是否可能在这些患者的转移形成中起预测作用。在 748 名患者中，通过免疫组织化学分析了 brachyury 同源物（T）的表达，并将数据与结直肠癌的经典和更新的预后标志物进行了相关性分析。当肿瘤组织中表达 brachyury 时，早期结直肠癌患者（T1-2N0M0，Dukes A）的生存时间显著降低，而在晚期肿瘤阶段则没有观察到相关性。因此，存在一小部分结直肠癌，其转移能力在肿瘤生长的早期阶段就已经存在，现在可以通过免疫组织化学检测到这个高风险群体。
