title: Bio-pathological factors of prognostic value in colorectal adenocarcinomas.
abstract: About 40% of patients bearing a colorectal carcinoma will develop local or distant tumor recurrences. Integrated analyses of biopathological markers, predictive of tumor aggressiveness, may offer a more rational approach to adjuvant therapy planning. To this end we analyzed the correlation between p53 accumulation, bcl-2 expression with cell proliferation, DNA ploidy, and conventional histological parameters, by testing the prognostic significance of these variables in a series of 214 patients bearing a colorectal carcinoma. When these parameters were examined in the univariate analysis, significantly shorter disease free and overall survival were observed in patients bearing p53+ and bcl-2- tumors. In the multivariate analysis p53 accumulation and bcl-2 expression emerged as independent predictors respectively of worse and better clinical outcome also in Dukes' B stage identifying patients at higher risk to develop liver metastases.. These results indicate that in colorectal adenocarcinomas a biological profile, based on the combined evaluation of p53 and bcl-2, can be useful in identifying high risk patients to be enrolled in an adjuvant setting mainly in early stage of the disease.
authors.affiliation: Pathology Department, Regina Elena Cancer Institute, Rome, Italy. mottolese@crs.ifo.it
authors.forename: M
authors.initials: M
authors.lastname: Mottolese
authors.forename: S
authors.initials: S
authors.lastname: Buglioli
authors.forename: G
authors.initials: G
authors.lastname: Piperno
authors.forename: I
authors.initials: I
authors.lastname: Sperduti
authors.forename: D
authors.initials: D
authors.lastname: Giannarelli
authors.forename: C
authors.initials: C
authors.lastname: D'Angelo
authors.forename: M
authors.initials: M
authors.lastname: Cosimelli
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology* / Q000556:secondary; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D049109:Cell Proliferation; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D011003:Ploidies; D011379:Prognosis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000096:biosynthesis*; D016019:Survival Analysis; D015996:Survival Rate; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; D019253:Proto-Oncogene Proteins c-bcl-2; D016159:Tumor Suppressor Protein p53