Department of Pathology, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai, China.
Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China.
Jpn J Clin Oncol. 2020 Apr 7;50(4):446-455. doi: 10.1093/jjco/hyz210.
The purpose of this study was to explore the prognostic role of c-MYC amplification in colorectal cancer, particularly in schistosomiasis-associated colorectal cancer.
Three hundred and fifty four cases of colorectal cancer, which were from Qingpu Branch of Zhongshan Hospital affiliated to Fudan University, were retrospectively analyzed in a tissue microarray (TMA) format, with fluorescence in situ hybridization (FISH) assay and immunohistochemistry (IHC).
c-MYC gene amplification was found in 14.1% (50 out of 354) of patients with colorectal cancer and was correlated with old age (P = 0.028), positive lymph node metastasis (P = 0.004) and advanced stage tumors (P = 0.002). The overexpression of c-MYC was closely associated with the amplification status (P = 0.023). Kaplan-Meier survival curves for overall survival (OS) showed a statistically significant difference for patients with c-MYC amplification in full cohort of colorectal cancer, stage III-IV set and patients with lymph node metastasis (P = 0.002, 0.034, 0.012, respectively). Further analysis found c-MYC amplification associated with poorer survival in the subgroup of colorectal cancer with schistosomiasis (CRC-S, P < 0.001), but not in colorectal cancer without schistosomiasis (CRC-NS, P = 0.155). By multivariate analysis, c-MYC amplification was an independent poor-prognostic factor in CRC-S set (P = 0.046).
Our study firstly found c-MYC amplification could predict poor prognosis in schistosomiasis-associated colorectal cancer, but not in colorectal cancer without schistosomiasis.
本研究旨在探讨 c-MYC 扩增在结直肠癌中的预后作用,特别是在血吸虫病相关结直肠癌中。
我们回顾性分析了来自复旦大学附属中山医院青浦分院的 354 例结直肠癌组织微阵列(TMA)标本,采用荧光原位杂交(FISH)和免疫组化(IHC)检测 c-MYC 基因扩增。
在 354 例结直肠癌患者中,发现有 14.1%(50/354)存在 c-MYC 基因扩增,且与患者年龄较大(P=0.028)、淋巴结转移阳性(P=0.004)和肿瘤晚期(P=0.002)有关。c-MYC 的过度表达与扩增状态密切相关(P=0.023)。总生存(OS)的 Kaplan-Meier 生存曲线显示,在全队列结直肠癌、III-IV 期和有淋巴结转移的患者中,c-MYC 扩增患者的生存存在统计学差异(P=0.002、0.034、0.012)。进一步分析发现,在血吸虫病相关结直肠癌(CRC-S)亚组中,c-MYC 扩增与较差的生存相关(P<0.001),但在非血吸虫病相关结直肠癌(CRC-NS)中则无相关性(P=0.155)。多因素分析显示,c-MYC 扩增是 CRC-S 组的独立不良预后因素(P=0.046)。
本研究首次发现 c-MYC 扩增可预测血吸虫病相关结直肠癌的不良预后,但不能预测非血吸虫病相关结直肠癌的预后。