Clinical application of malignancy potential grading as a prognostic factor of human esophageal cancers

Citation
H. Shiozaki et al., Clinical application of malignancy potential grading as a prognostic factor of human esophageal cancers, SURGERY, 127(5), 2000, pp. 552-561
Citations number
28
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Surgery,"Medical Research Diagnosis & Treatment
Journal title
SURGERY
ISSN journal
0039-6060 → ACNP
Volume
127
Issue
5
Year of publication
2000
Pages
552 - 561
Database
ISI
SICI code
0039-6060(200005)127:5<552:CAOMPG>2.0.ZU;2-2
Abstract
Background. Various biologic markers have been reported to be prognostic fa ctors in human esophageal cancers. In the current study, we established a n ew tumor-grading system representing the malignancy potential of cancer cel ls and compared it with the clinical-stage system. Methods. Tumor samples from 77 patients with squamous cell carcinoma of the esophagus were immunohistochemically evaluated for the expression of 10 mo lecules: the cell cycle-related molecules of cyclin D1, Rb, p16(INK4), P27( KIP1), and PCNA; the cell-cell adhesion molecules of E-cadherin, alpha-cate nin, and beta-catenin; and the heat shock proteins of HSP27 and HSP70. Results. p27(KIP1), beta-catenin, and HSP70 were selected for their high ha zard ratio in multivariate analysis, and the number of their disordered mol ecules was used to define the malignancy grade (MG). Five-year survival rat es were 83%, 54%, 17%, and 0% for MG1, MG2, MG3, and MG4. The gradation of survival curves was better for MGs than for clinical stages. MGs and clinic al stages showed significant correlation; however; 55% of those in higher c linical stages (stage 3 or 4) had lower MG (MG1 or 2) and showed better pro gnosis than others in their group (stage 3 or 4 and MG3 or 4). The proporti ons of shorter survival span to cancer death patients (less than I year) we re 0%, 33%, 75%, and 100% in MG1, 2, 3, and 4, but the clinical stage was n ot associated with the survival span. Conclusions. The grading of malignancy potential is clinically useful, espe cially for selecting patients who may show good prognosis in the advanced c linical stage and for predicting short survival span. These predictions are not possible with the clinical-stage system, which is based on the anatomi c spread of cancer cells.