Bio-pathological factors of prognostic value in colorectal adenocarcinomas.
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.
Mottolese
M
M
Pathology Department, Regina Elena Cancer Institute, Rome, Italy. mottolese@crs.ifo.it
Buglioli
S
S
Piperno
G
G
Sperduti
I
I
Giannarelli
D
D
D'Angelo
C
C
Cosimelli
M
M
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*
D014408:Biomarkers, Tumor; D019253:Proto-Oncogene Proteins c-bcl-2; D016159:Tumor Suppressor Protein p53