Journal of Clinical Oncology, Vol 15, 2008-2014, Copyright © 1997 by American Society of Clinical Oncology
Cell proliferation-related markers in colorectal liver metastases: correlation with patient prognosis
A Costa, R Doci, C Mochen, P Bignami, A Faranda, L Gennari and R Silvestrini
Oncologia Sperimentale C and Oncologia Chirurgica A, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milano, Italy.
PURPOSE: We analyzed the relation between phenotypic (DNA ploidy) and
functional markers (S-phase cell fraction, p53, and bcl-2 protein
expression) and defined their relevance on clinical outcome on a
retrospective series of radically resected liver metastases from colorectal
cancer. PATIENTS AND METHODS: Among 104 patients with resectable liver
metastases from colorectal cancer, DNA ploidy was determined by flow
cytometry, 3H-thymidine labeling index (TLI) by autoradiography, and
expression of p53 and bcl-2 by immunohistochemistry. RESULTS: TLI was a
significant indicator for relapse at 4 years from radical surgery, DNA
ploidy was a suggestive indicator of clinical outcome, and p53 and bcl-2
expression provided no clinical information. By multivariate analysis, cell
proliferation rate and Dukes' stage remained independent prognostic
parameters. In the most representative subgroup of patients with H1 liver
lesions (86 cases), TLI was always associated with relapse, and DNA ploidy
and p53 expression provided discriminant information within slowly
proliferating liver lesions. CONCLUSION: Tumor-cell proliferation of liver
lesions should be used with stage of the primary colorectal cancer for a
more accurate prognosis in patients submitted to curative hepatic
resection.
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