Alcaide Julia, Funez Rafael, Rueda Antonio, Perez-Ruiz Elisabeth, Pereda Teresa, Rodrigo Isabel, Coveñas Rafael, Muñoz Miguel, Redondo Maximino
Red de Investigacion en Servicios de Salud (REDISSEC), Spain.
BMC Clin Pathol. 2013 Oct 10;13(1):24. doi: 10.1186/1472-6890-13-24.
Alterations to apoptosis are a common occurrence in human tumours. The aim of our study was to determine the influence of apoptotic variations on the carcinogenesis and prognosis of colorectal carcinomas (CRCs).
A TUNEL assay was performed on archival material from 103 colorectal carcinomas, 26 adenomas and 20 samples of normal epithelia.
The number of apoptotic cells was higher in CRCs (1.09 ± 0.13) than in adenomas (0.38 ± 0.23, p = 0.059) and normal epithelium (0.06 ± 0.04, p = 0.001). In addition, the apoptotic index (AI) was greater in metastatic disease (stage IV) than in other stages (p = 0.017). No relationship was found between apoptotic rates and age, gender or tumour grade. However, patients with tumours that showed higher AI values had a significantly lower disease-free survival (DFS) and overall survival (OS) than those with tumours that had lower AIs (p = 0.020 and p = 0.027). In a multivariate Cox proportional hazards model, AI remained a significant independent predictor of survival.
We conclude that disregulated apoptosis is an important event during CRC development and progression. Higher AIs are associated with more aggressive tumours and a poorer prognosis for patients with CRC.
细胞凋亡改变在人类肿瘤中普遍存在。我们研究的目的是确定凋亡变化对结直肠癌（CRC）发生和预后的影响。
对103例结直肠癌、26例腺瘤和20例正常上皮组织的存档材料进行TUNEL检测。
结直肠癌中凋亡细胞数量（1.09±0.13）高于腺瘤（0.38±0.23，p = 0.059）和正常上皮组织（0.06±0.04，p = 0.001）。此外，转移性疾病（IV期）的凋亡指数（AI）高于其他阶段（p = 0.017）。未发现凋亡率与年龄、性别或肿瘤分级之间存在关联。然而，AI值较高的肿瘤患者的无病生存期（DFS）和总生存期（OS）显著低于AI值较低的肿瘤患者（p = 0.020和p = 0.027）。在多变量Cox比例风险模型中，AI仍然是生存的重要独立预测因素。
我们得出结论，细胞凋亡失调是结直肠癌发生和发展过程中的一个重要事件。较高的AI与更具侵袭性的肿瘤以及结直肠癌患者较差的预后相关。
