Percesepe A, Benatti P, Roncucci L, Sassatelli R, Fante R, Ganazzi D, Bellacosa A, Genuardi M, Neri G, Viel A, Ponz de Leon M
Department of Internal Medicine, University of Modena, Italy.
Int J Cancer. 1997 May 2;71(3):373-6. doi: 10.1002/(sici)1097-0215(19970502)71:3<373::aid-ijc12>3.0.co;2-h.
Previous survival studies suggested a better prognosis of hereditary nonpolyposis colorectal cancer (HNPCC) patients compared with the sporadic counterpart. In the present study we evaluated the clinical outcome of HNPCC patients with respect to that of patients with colorectal cancer recorded in a population-based cancer registry. We assessed survival of 85 colorectal cancer patients from 24 unrelated families defined as having HNPCC according to the criteria of the International Collaborative Group, for whom adequate information on subject- and tumor-related parameters and a 5-year follow-up (cancer diagnosis from 1980-1989) were available. Three hundred and seventy-seven colorectal cancer patients, registered from 1984-1986, with a 5-year follow-up, were used for comparison. Colorectal cancer-specific 5-year survival rates were 55.2% and 42.5% for HNPCC and non-HNPCC, respectively. Using Cox regression analysis, tumor staging and location were independently associated with survival, whereas HNPCC diagnosis was not. Stage II HNPCC cases exhibited a better prognosis than non-HNPCC patients. By Cox regression analysis, none of the variables were significantly related to survival. Both overall and stage II HNPCC cases showed a survival advantage in comparison with non-HNPCC patients. However, the difference disappeared when clinical and pathological variables were controlled for with a Cox regression analysis.
以往的生存研究表明，遗传性非息肉病性结直肠癌（HNPCC）患者的预后比散发性结直肠癌患者更好。在本研究中，我们根据一项基于人群的癌症登记数据，评估了HNPCC患者与结直肠癌患者的临床结局。我们评估了来自24个无关家庭的85例结直肠癌患者的生存情况，这些家庭根据国际协作组的标准被定义为患有HNPCC，我们掌握了这些患者与受试者及肿瘤相关参数的充分信息，并对其进行了5年随访（癌症诊断时间为1980 - 1989年）。选取了1984 - 1986年登记的、有5年随访记录的377例结直肠癌患者作为对照。HNPCC和非HNPCC患者的结直肠癌特异性5年生存率分别为55.2%和42.5%。采用Cox回归分析，肿瘤分期和位置与生存独立相关，而HNPCC诊断与生存无关。II期HNPCC病例的预后优于非HNPCC患者。通过Cox回归分析，没有变量与生存显著相关。总体而言，与非HNPCC患者相比，HNPCC病例无论是整体还是II期都显示出生存优势。然而，当用Cox回归分析控制临床和病理变量时，这种差异消失了。
