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Published in Cancer Detection and Prevention 2000; 24(4):343-355.

Altered Expression of p53 and p27 Proteins, Alone or Combined, as a Predictor of Metastatic Potential in Early Invasive Carcinoma of Colon and Rectum: A Comparative Clinicopathologic and Molecular Analysis

Kouichi Hirano, MD, and Toshinari Minamoto, MD, PhD

Divisions of Diagnostic Molecular Oncology and Surgical Oncology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan

Address all correspondence and reprint requests to: Toshinari Minamoto, MD, Divisions of Diagnostic Molecular Oncology and Surgical Oncology, Cancer Research Institute, Kanazawa University, 4-86 Yoneizumi, Kanazawa, Ishikawa 921-8044, Japan.

ABSTRACT: To place the choice of therapy (endoscopic resection or radical surgery) in early invasive carcinoma (EIC) of colon and rectum on a more rational basis, this study sought to identify molecular predictors of metastasis. Several morphologic risk factors (histologic type, degree of tumor invasion, lymphatic and venous invasion) and expression of p53 and p27 proteins in the primary tumor were compared in 80 patients with BIC, including 12 (15%) with metastasis or recurrence (or both). Of the factors enumerated, deeper invasion of the submucosal layer, lymphatic-venous invasion, p53 overexpression, and decreased expression of p27 were correlated significantly with metastasis. The results also indicated that altered expression of p53 or p27 is independently relevant to metastasis of BIC. Analysis of these markers, together with determination of the morphologic risk factors, could complement the identification of patients with metastasis on the basis of known morphologic risk factors. Because the molecular factors can be assessed more objectively than can the morphologic parameters, they may strengthen the ability to identify BIC that has undergone, or will undergo, metastasis.

KEY WORDS: clinical management, combined analysis, metastasis, risk factor, therapeutic option.

http://www.cancerprev.org/Journal/Issues/24/4/3070