DNA Ploidy and S-phase fraction, but not p53 or NM23-H1 expression, predict outcome in colorectal cancer patients. Result of a 5-year prospective study

• DOI: 10.1007/s00432-002-0394-6
• Publication Date: 2003-02-13T05:27:25Z
• Authors: Bazan V.; Migliavacca M.; Zanna I.; Tubiolo C.; Corsale S.; Calò V.; Amato A.; Cammareri P.; Latteri F.; Grassi N.; Fulfaro F.; Porcasi R.; Morello V.; Nuara R.; Dardanoni G.; Salerno S.; Valerio M.; Dusonchet L.; Gerbino A.; Gebbia N.; Tomasino R.; Russo A.
• Keywords: Ploidies; Time Factors; Colon; DNA, Neoplasm; Adenocarcinoma; NM23 Nucleoside Diphosphate Kinases; Adenocarcinoma, Mucinous; Immunohistochemistry; Survival Analysis; Disease-Free Survival; S Phase; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Predictive Value of Tests; Nucleoside-Diphosphate Kinase; Biomarkers, Tumor; Humans; Lymph Nodes; Colorectal Neoplasms; Cell Division; Monomeric GTP-Binding Proteins; Neoplasm Staging

The aim of this study was to determine TP53 and NM23-H1 immunoreactivity, DNA ploidy, and S-phase fraction (SPF) in a series of 160 patients undergoing resective surgery for primary operable colorectal cancer (CRC) and to establish whether these alterations have any clinical value in predicting CRC patients' prognosis.TP53 and NM23-H1 expressions were evaluated on paraffin-embedded tissue by immunohistochemistry and DNA-ploidy and SPF on frozen tissue by flow-cytometric analysis.The median follow-up time in our study group was 71 months (range 34-115 months). P53 protein expression was associated with distal tumors (P<0.05) and DNA aneuploid tumors (P<0.05) tumors. DNA-aneuploidy was associated with distal tumors (P<0.01), histological grade (G3) (P<0.05), advanced Dukes' stage (C and D) (P<0.01), lymph node metastases (P<0.01) and high SPF (>18.3%) (P<0.01). The major significant predictors for both disease relapse and death were advanced Dukes' stage, DNA-aneuploidy, and high SPF, while lymphohematic invasion was the only independent factor for relapse and non-curative resection for death.Our results indicate that DNA aneuploidy and high SPF are associated in CRC with a poor clinical 5-year outcome, while in contrast the prognostic role of TP53 and NM23-H1 expression is still to be clarified.