Influence of the c-erb B-2, nm23, bcl-2 and p53 protein markers on colorectal cancer

Under stringent intra-laboratory conditions we evaluated the relationship between the expression of four protein markers and clinicopathologic characteristics of colorectal tumors.

124 patients with colorectal cancer from 1999 to 2002 were assessed.

The expression of cerb B-2, nm23 and p53 was mostly determined in tumors located in the rectum. However, about 20% of the rectal lesions had bcl-2 expression. p53 and c-erb B-2 expression was significantly demonstrated in the lesions with vascular and lymph node involvement. However, the difference between the markers and staging was not statistically significant (p=0.388, p=0.301). Cerb B-2 and p53 were more frequently expressed in the patients with large tumors (more than 5 cm) with moderate and poor differentiation grade. About half of the tumors expressing c- erb B- 2 and p53 had vascular invasion and more than 70% had N1 and N2 lymphatic invasion as well. In the patients with tumors expressing c-erb B-2 and p53, recurrences often occurred and both disease-free survival (DFS) and overall survival (OS) in the first two years after surgery were shorter than of the patients with tumors expressing nm23 and bcl-2.

In this study, c-erb B-2 and p53 were frequently expressed in the Astler- Coller stage C large tumors located in the rectum and a high degree of vascular and lymphatic invasion was observed. In the patients with tumors expressing c-erb B-2 and p53, recurrences were determined more frequently and DFS and OS were shorter than in patients with tumors expressing nm23 and bcl-2. Thus, two different protein markers should be taken into consideration when evaluating the clinical outcome of patients with colorectal cancer.