Transforming growth factor alpha (TGF-alpha) expression in biopsies of colorectal carcinoma is a significant prognostic indicator.
BACKGROUND
Predicting the outcome of patients with colorectal adenocarcinoma (CRCA) prior to surgery would be valuable in selecting high-risk individuals who may benefit from pre-operative adjuvant therapy. The aim of this study is to determine whether the expression of TGF-alpha in preoperative biopsies of patients with CRCA constitutes a significant prognostic indicator.


METHODS
We studied the expression of TGF-alpha in preoperative biopsies of 106 patients with CRCA, who had at least 5 years follow-up, using an anti-TGF-alpha monoclonal antibody and utilizing the ABC immunoperoxidase technique. For survival analysis, we used the actuarial survival method, and the Log Rank test for statistical significance.


RESULTS
CRCAs with low TGF-alpha expression (less than 25% of the tumor cells immunoreactive for TGF-alpha) had a significantly poorer survival than those with high TGF-alpha expression (more than 25%). After excluding from analysis biopsies showing mucinous or poorly differentiated CRCA, known predictors of poor prognosis, the results remained significant (p = 0.0289).


CONCLUSIONS
It is concluded, therefore, that low or absent expression of TGF-alpha in pre-operative biopsies of patients with CRCA, as detected by immunohistochemistry, is a significant predictor of an unfavorable outcome.
Younes
M
M
Department of Pathology, Baylor College of Medicine, Houston, TX 77030, USA.
Fernandez
L
L
Lechago
J
J
D000206:Actuarial Analysis; D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D000911:Antibodies, Monoclonal; D001706:Biopsy; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D007150:Immunohistochemistry; D011237:Predictive Value of Tests; D011379:Prognosis; D016019:Survival Analysis; D016211:Transforming Growth Factor alpha / Q000032:analysis* / Q000096:biosynthesis
D000911:Antibodies, Monoclonal; D016211:Transforming Growth Factor alpha