The DCC protein and prognosis in colorectal cancer

被引:237
作者
Shibata, D
Reale, MA
Lavin, P
Silverman, M
Fearon, ER
Steele, G
Jessup, JM
Loda, M
Summerhayes, IC
机构
[1] HARVARD UNIV, NEW ENGLAND DEACONESS HOSP,SCH MED,DEPT SURG, LAB CANC BIOL, BOSTON, MA 02215 USA
[2] HARVARD UNIV, NEW ENGLAND DEACONESS HOSP, SCH MED, DEPT PATHOL, BOSTON, MA 02215 USA
[3] YALE UNIV, SCH MED, SECT MED ONCOL, NEW HAVEN, CT USA
[4] BOSTON BIOSTAT RES FDN, FRAMINGHAM, MA USA
[5] LAHEY HITCHCOCK MED CTR, DEPT PATHOL, BURLINGTON, MA USA
[6] UNIV MICHIGAN, MED CTR, DEPT INTERNAL MED, DIV MED & MOL GENET, ANN ARBOR, MI 48109 USA
关键词
D O I
10.1056/NEJM199612053352303
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Allelic loss of chromosome 18q predicts a poor outcome in patients with stage II colorectal cancer. Although the specific gene inactivated by this allelic loss has not been elucidated, the DCC (deleted in colorectal cancer) gene is a candidate. We investigated whether the expression of the DCC protein in tumor cells is a prognostic marker in colorectal carcinoma. Methods The expression of DCC was evaluated immunohistochemically in 132 paraffin-embedded samples from patients with curatively resected stage II or III colorectal carcinomas. The Cox proportional-hazards model was used to adjust for covariates including age, sex, tumor site, degree of tumor differentiation, and use of adjuvant therapy. Results The expression of DCC was a strong positive predictive factor for survival in both stage II and stage III colorectal carcinomas. In patients with stage II disease whose tumors expressed DCC, the five-year survival rate was 94.3 percent, whereas in patients with DCC-negative tumors, the survival rate was 61.6 percent (P<0.001). In patients with stage III disease, the respective survival rates were 59.3 percent and 33.2 percent (P = 0.03). Conclusions DCC is a prognostic marker in patients with stage II or stage III colorectal cancer. In stage II colorectal carcinomas, the absence of DCC identifies a subgroup of patients with lesions that behave like stage III cancers. These findings may thus have therapeutic implications in this group of (C) 1996, Massachusetts Medical Society.
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收藏
页码:1727 / 1732
页数:6
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