title: DNA topoisomerase II alpha: a favorable prognostic factor in colorectal caner.
abstract: OBJECTIVE
  There is a lack of study concerning expression of Topoisomerase IIα (Topo IIα) and long-term results in colorectal cancer patients. We aimed to investigate the relationship between expression of Topo IIα and clinicopathological parameters including overall survival in colorectal cancer.
  
  
  METHODS
  Paraffin-fixed specimens from a large prospective cohort of colorectal cancer patients who had been followed up for 4 years were assayed immunohistochemically.
  
  
  RESULTS
  Of 490 colorectal cancer patients accessible for Topo IIα expression, expression of Topo IIα was scored as (-) in 4 (0.8%) patients, (+) in 41 (8.4%) patients, (++) in 396 (80.8%) patients, and (+++) in 49 (10.0%) patients. Overexpression of Topo IIα was found to be related with lower T stage (p = 0.042), lower N stage (p = 0.038), and a lower incidence of recurrence with nearly significance (p = 0.053). Kaplan-Meier analyses showed that overexpression of Topo IIα was related with prolonged overall survival (p = 0.022) and disease-free survival (p = 0.036). Multivariate analyses showed that elevated serum CEA (p < 0.001), elevated serum CA199 (p = 0.002), poor differentiation (p = 0.001), advanced Dukes stage (p < 0.001), and lower expression of Topo IIα (p = 0.017) were independent predictive factors for poor prognosis.
  
  
  CONCLUSIONS
  Topo IIα expression is a valuable prognostic indicator for colorectal cancer and would be useful in treatment selection for early colorectal cancer and malignant colorectal polyps resected under endoscopy, especially when it is used in combination with serum CEA, CA199, and differentiation.
authors.affiliation: Department of Colorectal Surgery of Changhai Hospital, Second Military Medical University, Shanghai, 200433, China.
authors.forename: Xian Hua
authors.initials: XH
authors.lastname: Gao
authors.forename: Zhi Qi
authors.initials: ZQ
authors.lastname: Yu
authors.forename: Chang
authors.initials: C
authors.lastname: Zhang
authors.forename: Chen Guang
authors.initials: CG
authors.lastname: Bai
authors.forename: Jian Ming
authors.initials: JM
authors.lastname: Zheng
authors.forename: Chuan Gang
authors.initials: CG
authors.lastname: Fu
mesh_terms: D000368:Aged; D000951:Antigens, Neoplasm / Q000378:metabolism*; D015179:Colorectal Neoplasms / Q000201:enzymology* / Q000473:pathology; D004250:DNA Topoisomerases, Type II / Q000378:metabolism*; D004268:DNA-Binding Proteins / Q000378:metabolism*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000201:enzymology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models
chemical_list: D000951:Antigens, Neoplasm; D004268:DNA-Binding Proteins; D004250:DNA Topoisomerases, Type II
references.citation: Anticancer Res. 2009 Feb;29(2):785-91
references.pmid: 19331236
references.citation: Nat Rev Mol Cell Biol. 2002 Jun;3(6):430-40
references.pmid: 12042765
references.citation: Scand J Surg. 2003;92(1):25-33
references.pmid: 12705548
references.citation: Nat Clin Pract Oncol. 2004 Dec;1(2):104-11
references.pmid: 16264828
references.citation: Gene. 2004 Nov 10;342(1):145-55
references.pmid: 15527974
references.citation: Cancer Chemother Biol Response Modif. 2005;22:101-21
references.pmid: 16110609
references.citation: Cancer Lett. 2009 Apr 18;276(2):228-38
references.pmid: 19111388
references.citation: Pathol Res Pract. 2001;197(6):411-8
references.pmid: 11432668
references.citation: Cancer Res. 1991 Dec 15;51(24):6592-5
references.pmid: 1660343
references.citation: Zhonghua Wei Chang Wai Ke Za Zhi. 2005 Nov;8(6):524-7
references.pmid: 16299657
references.citation: Arch Pathol Lab Med. 2000 Jul;124(7):979-94
references.pmid: 10888773
references.citation: Cancer Lett. 2004 Dec 28;216(2):221-6
references.pmid: 15533598
references.citation: Lancet Oncol. 2009 Nov;10(11):1128
references.pmid: 19880067
references.citation: Colorectal Dis. 2008 May;10(4):344-51
references.pmid: 17949449
references.citation: Anticancer Res. 1999 Nov-Dec;19(6B):5393-8
references.pmid: 10697567
references.citation: Hum Pathol. 2004 Jun;35(6):745-51
references.pmid: 15188142
references.citation: World J Surg. 2007 Jul;31(7):1485-90
references.pmid: 17510767