title: P53 and bcl-2 in colorectal cancer arising in patients under 40 years of age: distribution and prognostic relevance.
abstract: Young people (40 years of age) with colorectal cancer (CRC) represent a distinct subgroup with more aggressive disease behaviour compared to older patients. We evaluate whether p53 and bcl-2 could be useful in identifying young patients at higher risk of tumour progression. We reviewed 1340 CRC patients with 58 patients 40 years (4.2%). They had more frequent moderately or poorly differentiated mucinous adenocarcinomas (26% versus 12.3%, p=0.03); higher advanced stage at diagnosis; shorter 5-year overall survival (49.8% versus 71%; p=0.02); more frequent p53 positive (89.8% versus 72.6%, p<0.05) and bcl-2 negative (88.0% versus 66.2%, p<0.05) tumours; no difference in DNA content or proliferation indexes. Moreover, p53+ and bcl-2- resulted in being independent predictors of survival with shorter survival for the p53+/bcl-2- patients. Combining p53 and bcl-2, we could identify young CRC patients at higher risk of progression, who probably require development of a more sophisticated therapeutic approach based on identification of predictive factors.
authors.affiliation: Medical Oncology C, Regina Elena Cancer Institute, Via Elio Chianesi 53, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Torsello
authors.forename: C
authors.initials: C
authors.lastname: Garufi
authors.forename: M
authors.initials: M
authors.lastname: Cosimelli
authors.forename: M G
authors.initials: MG
authors.lastname: Diodoro
authors.forename: M
authors.initials: M
authors.lastname: Zeuli
authors.forename: B
authors.initials: B
authors.lastname: Vanni
authors.forename: C
authors.initials: C
authors.lastname: Campanella
authors.forename: C
authors.initials: C
authors.lastname: D'Angelo
authors.forename: I
authors.initials: I
authors.lastname: Sperduti
authors.forename: R
authors.initials: R
authors.lastname: Perrone Donnorso
authors.forename: F
authors.initials: F
authors.lastname: Cognetti
authors.forename: E
authors.initials: E
authors.lastname: Terzoli
authors.forename: M
authors.initials: M
authors.lastname: Mottolese
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis / Q000502:physiology; D002471:Cell Transformation, Neoplastic / Q000473:pathology; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D019394:Ki-67 Antigen / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism*; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*
chemical_list: D019394:Ki-67 Antigen; D019253:Proto-Oncogene Proteins c-bcl-2; D016159:Tumor Suppressor Protein p53