title: Prognostic impact of genomic instability in colorectal cancer.
abstract: BACKGROUND
  The prognostic impact of an indication of chromosomal instability (CIN) is evaluated in a consecutive series of 952 colorectal cancer patients treated at Aker University Hospital, Norway, during 1993-2003. Microsatellite instability (MSI) in this case series has recently been reported and made it possible to find the co-occurrence and compare the prognostic significance of CIN and MSI.
  
  
  METHODS
  Data sets for overall survival (OS; n=855) and time to recurrence (TTR; n=579) were studied. To reveal CIN we used automated image cytometry (ICM). Non-diploid histograms were taken as indicative of the presence of CIN. PCR-based measures of MSI in this material have already been described.
  
  
  RESULTS
  As with MSI, CIN was found to be an independent predictor of early relapse and death among stage II patients (TTR: n=278: HR 2.19 (95% CI: 1.35-3.55), P=0.002). Of the MSI tumours (16%), 71% were found to be DNA diploid, 21% were DNA tetraploid and 8% were DNA aneuploid. Among microsatellite stable tumours, 24% were DNA diploid, 15% were DNA tetraploid and 61% were DNA aneuploid.
  
  
  CONCLUSIONS
  For patients presenting with stage II disease, genomic instability as detected by DNA image cytometry has the potential to provide a useful biomarker for relapse and cancer-related death following surgery with curative intent.
authors.affiliation: 1] Institute for Cancer Genetics and Informatics, Oslo University Hospital, PO Box 4950 Nydalen, 0424 Oslo, Norway [2] Centre for Cancer Biomedicine, University of Oslo, PO Box 4950 Nydalen, 0424 Oslo, Norway [3] Department of Informatics, University of Oslo, PO Box 1080 Blindern, 0316 Oslo, Norway.
authors.forename: T S
authors.initials: TS
authors.lastname: Hveem
authors.affiliation: 1] Centre for Cancer Biomedicine, University of Oslo, PO Box 4950 Nydalen, 0424 Oslo, Norway [2] Department of Cancer Prevention, Institute for Cancer Research, Oslo University Hospital, PO Box 4953 Nydalen, 0424 Oslo, Norway [3] Institute of Clinical Medicine, University of Oslo, PO Box 1171 Blindern, 0318 Oslo, Norway.
authors.forename: M A
authors.initials: MA
authors.lastname: Merok
authors.affiliation: 1] Institute for Cancer Genetics and Informatics, Oslo University Hospital, PO Box 4950 Nydalen, 0424 Oslo, Norway [2] Centre for Cancer Biomedicine, University of Oslo, PO Box 4950 Nydalen, 0424 Oslo, Norway.
authors.forename: M E
authors.initials: ME
authors.lastname: Pretorius
authors.affiliation: 1] Centre for Cancer Biomedicine, University of Oslo, PO Box 4950 Nydalen, 0424 Oslo, Norway [2] Department of Pathology, University College Hospital, London WC1E 6JJ, UK.
authors.forename: M
authors.initials: M
authors.lastname: Novelli
authors.affiliation: 1] Institute for Cancer Genetics and Informatics, Oslo University Hospital, PO Box 4950 Nydalen, 0424 Oslo, Norway [2] Centre for Cancer Biomedicine, University of Oslo, PO Box 4950 Nydalen, 0424 Oslo, Norway.
authors.forename: M S
authors.initials: MS
authors.lastname: Bævre
authors.affiliation: Department of Gastrointestinal Surgery, Oslo University Hospital, PO Box 4950 Nydalen, 0424 Oslo, Norway.
authors.forename: O H
authors.initials: OH
authors.lastname: Sjo
authors.affiliation: Institute for Cancer Genetics and Informatics, Oslo University Hospital, PO Box 4950 Nydalen, 0424 Oslo, Norway.
authors.forename: N
authors.initials: N
authors.lastname: Clinch
authors.affiliation: 1] Centre for Cancer Biomedicine, University of Oslo, PO Box 4950 Nydalen, 0424 Oslo, Norway [2] Department of Informatics, University of Oslo, PO Box 1080 Blindern, 0316 Oslo, Norway.
authors.forename: K
authors.initials: K
authors.lastname: Liestøl
authors.affiliation: 1] Institute of Clinical Medicine, University of Oslo, PO Box 1171 Blindern, 0318 Oslo, Norway [2] Department of Pathology, Oslo University Hospital, PO Box 4950 Nydalen, 0424 Oslo, Norway.
authors.forename: A
authors.initials: A
authors.lastname: Svindland
authors.affiliation: 1] Centre for Cancer Biomedicine, University of Oslo, PO Box 4950 Nydalen, 0424 Oslo, Norway [2] Department of Cancer Prevention, Institute for Cancer Research, Oslo University Hospital, PO Box 4953 Nydalen, 0424 Oslo, Norway [3] Institute of Clinical Medicine, University of Oslo, PO Box 1171 Blindern, 0318 Oslo, Norway.
authors.forename: R A
authors.initials: RA
authors.lastname: Lothe
authors.affiliation: 1] Centre for Cancer Biomedicine, University of Oslo, PO Box 4950 Nydalen, 0424 Oslo, Norway [2] Institute of Clinical Medicine, University of Oslo, PO Box 1171 Blindern, 0318 Oslo, Norway [3] Department of Gastrointestinal Surgery, Oslo University Hospital, PO Box 4950 Nydalen, 0424 Oslo, Norway.
authors.forename: A
authors.initials: A
authors.lastname: Nesbakken
authors.affiliation: 1] Institute for Cancer Genetics and Informatics, Oslo University Hospital, PO Box 4950 Nydalen, 0424 Oslo, Norway [2] Centre for Cancer Biomedicine, University of Oslo, PO Box 4950 Nydalen, 0424 Oslo, Norway [3] Department of Informatics, University of Oslo, PO Box 1080 Blindern, 0316 Oslo, Norway [4] Nuffield Division of Clinical Laboratory Sciences, University of Oxford, Oxford, UK.
authors.forename: H E
authors.initials: HE
authors.lastname: Danielsen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000782:Aneuploidy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000235:genetics* / Q000473:pathology; D004273:DNA, Neoplasm / Q000235:genetics; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D053842:Microsatellite Instability; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000235:genetics; D009367:Neoplasm Staging; D009664:Norway; D011379:Prognosis
chemical_list: D004273:DNA, Neoplasm