Lanza G, Matteuzzi M, Gafá R, Orvieto E, Maestri I, Santini A, del Senno L
Dipartimento di Medicina Sperimentale e Diagnostica, Università di Ferrara, Italy.
Int J Cancer. 1998 Aug 21;79(4):390-5. doi: 10.1002/(sici)1097-0215(19980821)79:4<390::aid-ijc14>3.0.co;2-9.
The prognostic significance of chromosome 18q allelic loss was evaluated in a series of 118 patients with curatively resected TNM stage II or stage III colon cancer. Chromosome 18q status was determined on frozen tumour samples, using microsatellite markers and the polymerase chain reaction (PCR). Mean follow-up in surviving patients was 75.9 months. Chromosome 18q allelic loss was significantly related to tumour site, extramural venous invasion, flow cytometric nuclear DNA content and p53 protein expression. Patients whose tumour had no evidence of chromosome 18q allelic loss showed a better disease-free and overall survival than patients whose tumour demonstrated 18q allelic loss. When patients were stratified by tumour stage, a significant survival advantage for patients whose tumour had no allelic loss on chromosome 18q was observed in stage II as well as in stage III disease. In particular, patients with stage II disease whose tumour had no chromosome 18q allelic loss demonstrated an excellent clinical outcome, with a 5-year disease-free survival rate of 96%. In contrast, the 5-year disease-free survival rate of patients with stage II disease and chromosome 18q allelic loss was only 54%. In multivariate analysis, status of chromosome 18q was the only significant independent prognostic factor for both disease-free and overall survival. These results indicate that assessment of chromosome 18q status provides relevant prognostic information in colon cancer and might be employed in the selection of patients for adjuvant therapy.
在118例接受根治性切除的TNM II期或III期结肠癌患者中，评估了18号染色体等位基因缺失的预后意义。使用微卫星标记和聚合酶链反应（PCR），在冷冻肿瘤样本上确定18号染色体状态。存活患者的平均随访时间为75.9个月。18号染色体等位基因缺失与肿瘤部位、壁外静脉侵犯、流式细胞术核DNA含量和p53蛋白表达显著相关。肿瘤无18号染色体等位基因缺失证据的患者，其无病生存期和总生存期均优于肿瘤有18号染色体等位基因缺失的患者。当按肿瘤分期对患者进行分层时，在II期和III期疾病中，均观察到肿瘤无18号染色体等位基因缺失的患者具有显著的生存优势。特别是，II期疾病且肿瘤无18号染色体等位基因缺失的患者表现出极佳的临床结局，5年无病生存率为96%。相比之下，II期疾病且有18号染色体等位基因缺失的患者5年无病生存率仅为54%。在多变量分析中，18号染色体状态是无病生存期和总生存期唯一显著的独立预后因素。这些结果表明，评估18号染色体状态可为结肠癌提供相关的预后信息，并可能用于辅助治疗患者的选择。
