A Nasierowska-Guttmejer1. 1. Department of Pathology, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warszawa.
Abstract
UNLABELLED: The aim of the study was to determine prognostic histopathological and immunohistochemical factors expressed by proliferation and apoptosis markers in patients treated only surgically or by preoperative radio-chemotherapy. The material was obtained from 204 patients; 114 patients underwent an operation, 35 patients had preoperative radiotherapy (2500 cGy in 5 fractions for 5 days) and 55 patients were treated with preoperative radio-chemotherapy (5000 cGy in 25 fractions for 33 days and 3 courses of chemotherapy 5Fu and Leucovorin). In 204 cases the operative material was examined taking into account: 1. the age, sex, size of tumor, macroscopic features, stage, angioinvasion and perineural invasion, 2. cancer response to the treatment, 3. immunohistochemical factors being the expression of p53, MIB1, bcl-2, bax. In additional, a statistic analysis was carried out using chi-square test and NW method to examine individual parameters and Spearman (R) rank correlation to define the force of dependence. RESULTS: 1. In cases of colorectal cancer treated only surgically, statistically significant correlations occurred among the stage, angioinvasion and perineural invasion. 2. The partial response with regression of the tumor mass less than 2/3 occurred in 90% of patients after short radiotherapy. The complete response (CR) was seen in 15% of cases, the regression of the tumor mass more than 2/3 (PR1)--in 46% of cases and the regression of the tumor mass less than 2/3 of (PR2)--in 39% of cases after preoperative radio-chemotherapy. 3. A. In biopsy taken in 27 patients before radio-chemotherapy expression of MIB1 and bax proved to be statistically significant. The low expression of MIB1 and the high level of bax expression were correlated with the total or near-total response of cancer to the treatment. B. In operative material after radio-chemotherapy a statistically significant dependence occurred among all immunohistochemical markers; regression of the tumor mass less than 2/3 correlated with the low expression of p53, MIB1, bax and bcl-2. 4. The force of dependence among immunohistochemical parameters in patients only after surgical treatment was R = 0.2-0.3 and after radio-chemotherapy R = 0.8. CONCLUSION: The expression of proliferation and apoptosis markers was combined with rectal carcinoma after preoperative radio-chemotherapy.
UNLABELLED: The aim of the study was to determine prognostic histopathological and immunohistochemical factors expressed by proliferation and apoptosis markers in patients treated only surgically or by preoperative radio-chemotherapy. The material was obtained from 204 patients; 114 patients underwent an operation, 35 patients had preoperative radiotherapy (2500 cGy in 5 fractions for 5 days) and 55 patients were treated with preoperative radio-chemotherapy (5000 cGy in 25 fractions for 33 days and 3 courses of chemotherapy 5Fu and Leucovorin). In 204 cases the operative material was examined taking into account: 1. the age, sex, size of tumor, macroscopic features, stage, angioinvasion and perineural invasion, 2. cancer response to the treatment, 3. immunohistochemical factors being the expression of p53, MIB1, bcl-2, bax. In additional, a statistic analysis was carried out using chi-square test and NW method to examine individual parameters and Spearman (R) rank correlation to define the force of dependence. RESULTS: 1. In cases of colorectal cancer treated only surgically, statistically significant correlations occurred among the stage, angioinvasion and perineural invasion. 2. The partial response with regression of the tumor mass less than 2/3 occurred in 90% of patients after short radiotherapy. The complete response (CR) was seen in 15% of cases, the regression of the tumor mass more than 2/3 (PR1)--in 46% of cases and the regression of the tumor mass less than 2/3 of (PR2)--in 39% of cases after preoperative radio-chemotherapy. 3. A. In biopsy taken in 27 patients before radio-chemotherapy expression of MIB1 and bax proved to be statistically significant. The low expression of MIB1 and the high level of bax expression were correlated with the total or near-total response of cancer to the treatment. B. In operative material after radio-chemotherapy a statistically significant dependence occurred among all immunohistochemical markers; regression of the tumor mass less than 2/3 correlated with the low expression of p53, MIB1, bax and bcl-2. 4. The force of dependence among immunohistochemical parameters in patients only after surgical treatment was R = 0.2-0.3 and after radio-chemotherapy R = 0.8. CONCLUSION: The expression of proliferation and apoptosis markers was combined with rectal carcinoma after preoperative radio-chemotherapy.