EVALUATION OF MULTIPLE BIO-PATHOLOGICAL FACTORS IN COLORECTAL ADENOCARCINOMAS: INDEPENDENT PROGNOSTIC ROLE OF p53 AND Bcl-2
Academic Article
Publication Date:
1999
abstract:
About 40% of patients with colorectal carcinoma will
develop local or distant tumour recurrences. Integrated
analyses of bio-pathological markers, predictive of tumour
aggressiveness, may offer a more rational approach to planning
adjuvant therapy. To this end, we analysed the correlation
between p53 accumulation, Bcl-2 expression,DNAploidy,
cell proliferation and conventional clinico-pathological parameters
by testing the prognostic significance of these variables
in a series of 171 colorectal carcinoma patients with longterm
follow-up. The relationships among the various biopathological
parameters, analysed by multiple correspondence
analysis, showed 2 different clinico-biological profiles.
The first, characterised by p53 negativity, Bcl-2 positivity,
diploidy, low percentage of cells in S-phase (%S-phase), a low
Ki-67 score, is associated with Dukes' A-B stage, well differentiated
tumours and lack of relapse. The second, defined by
p53 positivity, Bcl-2 negativity, aneuploidy, high %S-phase and
elevated Ki-67 score, correlates with Dukes' C-D stage,
poorly differentiated tumours and presence of relapse. When
these parameters were examined according to Kaplan-
Meier's method, significantly shorter disease-free (DFS) and
overall survival (OS) were also observed in patients bearing
p53 positive and Bcl-2 negative tumours, in Dukes' B stage. In
multivariate analysis, p53 accumulation and Bcl-2 expression
emerged as independent predictors of a worse and better
clinical outcome, respectively. Our results indicate that, in
colorectal adenocarcinomas, a biological profile, based on the
combined evaluation of p53 and Bcl-2, may be useful for
identifying high risk patients to be enrolled in an adjuvant
setting, mainly in an early stage of the disease.
develop local or distant tumour recurrences. Integrated
analyses of bio-pathological markers, predictive of tumour
aggressiveness, may offer a more rational approach to planning
adjuvant therapy. To this end, we analysed the correlation
between p53 accumulation, Bcl-2 expression,DNAploidy,
cell proliferation and conventional clinico-pathological parameters
by testing the prognostic significance of these variables
in a series of 171 colorectal carcinoma patients with longterm
follow-up. The relationships among the various biopathological
parameters, analysed by multiple correspondence
analysis, showed 2 different clinico-biological profiles.
The first, characterised by p53 negativity, Bcl-2 positivity,
diploidy, low percentage of cells in S-phase (%S-phase), a low
Ki-67 score, is associated with Dukes' A-B stage, well differentiated
tumours and lack of relapse. The second, defined by
p53 positivity, Bcl-2 negativity, aneuploidy, high %S-phase and
elevated Ki-67 score, correlates with Dukes' C-D stage,
poorly differentiated tumours and presence of relapse. When
these parameters were examined according to Kaplan-
Meier's method, significantly shorter disease-free (DFS) and
overall survival (OS) were also observed in patients bearing
p53 positive and Bcl-2 negative tumours, in Dukes' B stage. In
multivariate analysis, p53 accumulation and Bcl-2 expression
emerged as independent predictors of a worse and better
clinical outcome, respectively. Our results indicate that, in
colorectal adenocarcinomas, a biological profile, based on the
combined evaluation of p53 and Bcl-2, may be useful for
identifying high risk patients to be enrolled in an adjuvant
setting, mainly in an early stage of the disease.
Iris type:
01.01 Articolo in rivista
List of contributors:
D'Agnano, Igea
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