Kato M, Ito Y, Kobayashi S, Isono K
Second Department of Surgery, Chiba University, School of Medicine, Japan.
Cancer. 1996 Apr 15;77(8 Suppl):1729-35. doi: 10.1002/(SICI)1097-0142(19960415)77:8<1729::AID-CNCR47>3.0.CO;2-Z.
The mortality of patients with colorectal carcinoma depends mainly upon subsequent liver metastasis even after curative operation. However, it is very difficult to predict the incidence of liver metastasis by analyzing conventional tumor markers or pathologic findings. In the current study, the authors examined the genetic alterations of p53/DCC loci and Ki-ras in colorectal carcinoma in relation to liver metastasis, and investigated whether these gene alterations could be prognostic markers for liver metastasis.
Primary tumor tissue samples were collected at surgery from 30 patients with no liver metastasis and 24 patients with liver metastasis. Among the 30 patients with no liver metastasis at surgery, 9 developed liver metastasis after surgery. After the extraction of DNA, we investigated the loss of heterozygosity at p53/DCC loci and mutations of Ki-ras codon 12 in the colorectal carcinoma tissue from these patients.
The incidence of allelic loss of the DCC locus was significantly greater for patients with liver metastasis that for patients who had no liver metastasis for more than 2 years (19/20:95% vs 2/5:40%, P < 0.05). However, mutations of Ki-ras codon 12 were significantly less in patients with liver metastasis than in patients with no liver metastasis for more than 2 years (6/33:18% vs 6/11:55%, P < 0.05).
The current study indicated that detection of allelic loss of DCC and absence of Ki-ras codon 12 mutations are associated with the metastatic potential of colorectal carcinoma in the liver. These results suggested that these gene alterations might be reliable biologic markers for assessing the potential of liver metastasis after colorectal resection.
即使在根治性手术后,结直肠癌患者的死亡率主要仍取决于随后发生的肝转移。然而,通过分析传统肿瘤标志物或病理结果来预测肝转移的发生率非常困难。在本研究中,作者检测了结直肠癌中p53/DCC基因座和Ki-ras的基因改变与肝转移的关系,并研究这些基因改变是否可作为肝转移的预后标志物。
手术时收集了30例无肝转移患者和24例有肝转移患者的原发肿瘤组织样本。在这30例手术时无肝转移的患者中,有9例术后发生了肝转移。提取DNA后,我们研究了这些患者结直肠癌组织中p53/DCC基因座的杂合性缺失以及Ki-ras密码子12的突变情况。
肝转移患者中DCC基因座等位基因缺失的发生率显著高于无肝转移且生存超过2年的患者(19/20:95% 对 2/5:40%,P < 0.05)。然而,肝转移患者中Ki-ras密码子12的突变显著少于无肝转移且生存超过2年的患者(6/33:18% 对 6/11:55%,P < 0.05)。
本研究表明,检测DCC等位基因缺失和Ki-ras密码子12无突变与结直肠癌肝转移潜能相关。这些结果提示,这些基因改变可能是评估结直肠癌切除术后肝转移潜能的可靠生物学标志物。