title: Inflammatory infiltration, fibrosis, necrosis and mucinous content in relation to clinicopathological and molecular factors in rectal cancers with or without preoperative radiotherapy.
abstract: The association between inflammatory infiltration, fibrosis, necrosis and mucinous content in rectal cancers, and their relationship to preoperative radiotherapy (RT) clinicopathological and biological factors (p53, apoptosis and Cox-2) is not fully characterised. We analysed these histopathological parameters and their relationships in rectal cancer patients who participated in a clinical trial of preoperative RT. One hundred and forty-eight preoperative biopsies and 153 surgically resected tumours were examined. Of the surgical specimens, 81 had surgery alone and 72 received RT before surgery. A higher grade of inflammatory infiltration was related to favourable survival in the whole group of patients (p=0.004, for multivariate analysis p=0.01) as well as in the subgroups of patients with (p=0.04) or without RT (p=0.01). After RT, tumours showed a decreased infiltration (p=0.0003) and increased necrosis (p=0.006), strong necrosis was related to favourable survival (p=0.046). Necrosis (p=0.054) and fibrosis (p=0.06) tended to be increased in p53-negative tumours after RT. Inflammatory infiltration was a strong prognostic factor in rectal cancer patients, regardless of RT. RT tended to induce necrosis and fibrosis in p53-negative tumours.
authors.affiliation: Institute of Biomedicine and Surgery, Department of Oncology, Linköping University, Linköping, Sweden.
authors.forename: Annica
authors.initials: A
authors.lastname: Knutsen
authors.forename: Gunnar
authors.initials: G
authors.lastname: Adell
authors.forename: Xiao-Feng
authors.initials: XF
authors.lastname: Sun
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005355:Fibrosis; D006801:Humans; D007249:Inflammation / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009077:Mucins / Q000032:analysis; D009336:Necrosis / Q000473:pathology; D012004:Rectal Neoplasms / Q000473:pathology* / Q000532:radiotherapy*
chemical_list: D009077:Mucins