TUMOR PROLIFERATION IN RECTAL-CANCER FOLLOWING PREOPERATIVE IRRADIATION

被引：98

作者：

WILLETT, CG

WARLAND, G

HAGAN, MP

DALY, WJ

COEN, J

SHELLITO, PC

COMPTON, CC

机构：

[1] HARVARD UNIV,MASSACHUSETTS GEN HOSP,SCH MED,DEPT PATHOL,BOSTON,MA 02114

[2] HARVARD UNIV,MASSACHUSETTS GEN HOSP,SCH MED,DEPT GEN SURG,BOSTON,MA 02114

来源：

JOURNAL OF CLINICAL ONCOLOGY | 1995年 / 13卷 / 06期

关键词：

D O I：

10.1200/JCO.1995.13.6.1417

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: This study examines the effect of preoperative irradiation on tumor proliferation in rectal cancer. Patients and Methods: One hundred twenty-two patients with locally advanced rectal cancer received 45 to 50 Gy of preoperative irradiation followed by surgery, Pretreatment tumor biopsies and postirradiation surgical specimens were scored for proliferative activity by assaying the extent of Ki-67 and proliferating-cell nuclear antigen (PCNA) immunostaining and the number of mitoses per 10 high-power fields (hpf), Preirradiation and postirradiation proliferative activity was determined and correlated to clinical outcome. Results: There was an overall reduction in the tumor proliferative activity of rectal cancer after irradiation compared with its preirradiation state. Decreases in the activity of all three markers of tumor proliferation (Ki-67 and PCNA immunostaining, and mitotic counts) were observed in irradiated tumors compared with pretreatment biopsies, postirradiation tumor proliferative activity was associated with pathologic tumor stage. A high level of proliferative activity was observed in tumors downstaged to the rectal wall (T1-2) compared with tumors that retained transmural penetration (T3-4), Multivariate analysis indicated that postirradiation proliferative activity and stage were independently associated with survival following surgery. patients with tumors that exhibited elevated proliferative activity postirradiation had improved survival compared with patients with tumors that showed less proliferative activity. Conclusion: Moderate- to high-dose preoperative irradiation decreases both the tumor size and proliferative activity of rectal cancers, Elevated postirradiation tumor proliferative activity correlates strongly with improved survival. This may aid in identifying high-risk patients following preoperative irradiation and surgery. (C) 1995 by American Society of Clinical Oncology.

引用

页码：1417 / 1424

页数：8

共 42 条

[1]

Willett C.G., Warland G., Cheek R., Et al., Proliferating cell nuclear antigen in rectal cancer: Predictor of response to preoperative irradiation, J Clin Oncol, 12, pp. 679-682, (1994)

[2]

Willett C.G., Warland G., Coen J., Et al., Rectal cancer: The influence of tumor proliferation on response to pre-operative irradiation, Int J Radiat Oncol Biol Phys, 32, pp. 57-61, (1995)

[3]

Golick M.L., Rice M., Optimum staining of PCNA in paraffin sections is dependent on fixation, drying, and intesification, J Histotechnol, 15, pp. 39-41, (1992)

[4]

Willett C.G., Shellito P.C., Tepper J.E., Et al., Intraoperative electron beam radiation therapy for primary locally advanced rectal and rectosigmoid carcinoma, J Clin Oncol, 9, pp. 843-849, (1991)

[5]

Willett C.G., Shellito P.C., Rodkey G.V., Et al., Preoperative irradiation for tethered rectal carcinoma, Radiother Oncol, 21, pp. 141-142, (1991)

[6]

Kaplan E.L., Meier P., Nonparametric estimation for incomplete observations, J Am Stat Assoc, 53, pp. 457-481, (1958)

[7]

Berlingin E., Heenen M., Galand P., Measurement of S phase duration in human epidermis using cyclin immunostaining and tritiated thymidine pulse-labelling, Arch Dermatol Res, 284, pp. 238-241, (1992)

[8]

Bravo R., Frank R., Blundell P.A., Et al., Cyclin/PCNA is the auxiliary protein of DNA polymerase-S, Nature, 326, pp. 515-517, (1987)

[9]

Fontanini G., Macchiarini P., Pepe S., Et al., The expression of proliferating cell nuclear antigen in paraffin sections of peripheral, node-negative non-small cell lung cancer, Cancer, 70, pp. 1520-1527, (1991)

[10]

Fontanini G., Pingitore R., Bigini D., Et al., Growth fraction in non-small cell lung cancer estimated by proliferating cell nuclear antigen and comparison with Ki-67 labeling and DNA flow cytometry data, Am J Pathol, 141, pp. 1285-1290, (1992)

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