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Apoptosis as a prognostic factor in colorectal carcinoma
K Sugamura1, M Makino, N Kaibara
1First Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Japan.
Surgery Today
|April 3, 1998
Summary
Reduced apoptosis in colorectal cancer cells correlates with higher malignancy and poorer survival rates. Apoptosis frequency may serve as a prognostic indicator for colorectal carcinoma progression.
Area of Science:
- Oncology
- Cell Biology
- Cancer Research
Background:
- Apoptosis, or programmed cell death, plays a critical role in tissue homeostasis.
- Its dysregulation is implicated in various cancers, including colorectal carcinoma.
- Understanding apoptosis's role may offer prognostic insights.
Purpose of the Study:
- To investigate the occurrence of apoptotic cell death in colorectal carcinomas.
- To determine if the apoptotic index (AI) is a useful prognostic factor.
- To correlate apoptosis rates with tumor stage, differentiation, and metastasis.
Main Methods:
- Evaluated 104 colorectal carcinomas using terminal-deoxynucleotidyl-transferase-mediated dUTP-diotin nick end-labeling (TUNEL) assay.
- Calculated the apoptotic index (AI) as the percentage of apoptotic cancer cells per 1,000 cells.
- Correlated AI with Dukes staging, tumor differentiation, venous invasion, and lymph node metastasis.
Main Results:
- Apoptosis was less frequent in advanced Dukes stages (B, C, D) compared to stage A.
- Lower AI was observed in moderately differentiated tumors versus well-differentiated tumors.
- Reduced apoptosis correlated with venous invasion and lymph node metastasis (P < 0.05).
- Patients with low AI (<4.1) in Dukes stage C had significantly poorer 5-year survival (33% vs. 68%, P < 0.05).
Conclusions:
- Less apoptosis is associated with increased colorectal carcinoma progression and higher malignancy.
- The rate of apoptosis appears to be a valuable indicator of malignancy.
- Apoptosis frequency is a potentially useful prognostic factor in colorectal carcinoma.
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