| 1. |
- Halvarsson, Britta, et al.
(författare)
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Clinicopathologic factors identify sporadic mismatch repair-defective colon cancers.
- 2008
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Ingår i: American Journal of Clinical Pathology. - 1943-7722. ; 129:2, s. 238-244
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Tidskriftsartikel (refereegranskat)abstract
- Identification of sporadic mismatch repair (MMR)-defective colon cancers is increasingly demanded for decisions on adjuvant therapies. We evaluated clinicopathologic factors for the identification of these prognostically favorable tumors. Histopathologic features in 238 consecutive colon cancers were linked to MMR status based on immunostaining and BRAF mutation status.MMR defects were identified in 22.7% of the tumors, with 46 classified as sporadic. When the clinical parameters of age, sex, and proximal tumor location were combined with the morphologic features with the highest relative risks (RRs), eg, mucinous differentiation (RR, 9.0), tumor-infiltrating lymphocytes (RR, 7.5), absence of necrosis (RR, 7.5), and expanding growth pattern (RR, 5.0) into a 7-factor index, the presence of at least 4 features identified the MMR-defective tumors with 92.3% sensitivity and 75.3% specificity and excluded 61.5% of the tumors from MMR testing. This clinicopathologic index thus successfully selects MMR-defective colon cancers.
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| 2. |
- Kressner, Marit, et al.
(författare)
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The impact of hospital volume on surgical outcome in patients with rectal cancer.
- 2009
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Ingår i: Diseases of the colon and rectum. - 1530-0358 .- 0012-3706. ; 52:9, s. 1542-9
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: This study was designed to investigate, in a population-based setting, the surgical outcome in patients with rectal cancer according to the hospital volume. METHODS: Since 1995 all patients with rectal cancer have been registered in the Swedish Rectal Cancer Registry. Hospitals were classified, according to number treated per year, as low-volume, intermediate-volume, or high-volume hospitals (<11, 11-25, or >25 procedures per year). Postoperative mortality, reoperation rate within 30 days, local recurrence rate, and overall five-year survival were studied. For postoperative morbidity and mortality the whole cohort from 1995 to 2003 (n = 10,425) was used. For cancer-related outcome only, those with five-year follow-ups, from 1995 to 1998, were used (n = 4,355). RESULTS: In this registry setting the postoperative mortality rate was 3.6% in low-volume hospitals, and 2.2% in intermediate-volume and high-volume hospitals (P = 0.002). The reoperation rate was 10%, with no differences according to volume. The overall local recurrence rates were 9.4%, 9.3%, and 7.5%, respectively (P = 0.06). Significant difference was found among the nonirradiated patients (P = 0.004), but not among the irradiated patients (P = 0.45). No differences were found according to volume in the absolute five-year survival. CONCLUSION: Postoperative mortality and local recurrence in nonirradiated patients were lower in high-volume hospitals. No difference was seen between volumes in reoperation rates, overall local recurrence, or absolute five-year survival.
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| 3. |
- Ohlsson, Lina, et al.
(författare)
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Biomarker selection for detection of occult tumour cells in lymph nodes of colorectal cancer patients using real-time quantitative RT-PCR
- 2006
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Ingår i: British Journal of Cancer. - London : Harcourt Publishers. - 0007-0920 .- 1532-1827. ; 95:2, s. 218-225
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Tidskriftsartikel (refereegranskat)abstract
- Accurate identification of lymph node involvement is critical for successful treatment of patients with colorectal carcinoma (CRC). Real-time quantitative RT–PCR with a specific probe and RNA copy standard for biomarker mRNA has proven very powerful for detection of disseminated tumour cells. Which properties of biomarker mRNAs are important for identification of disseminated CRC cells? Seven biomarker candidates, CEA, CEACAM1-S/L, CEACAM6, CEACAM7-1/2, MUC2, MMP7 and CK20, were compared in a test-set of lymph nodes from 51 CRC patients (Dukes' A–D) and 10 controls. Normal colon epithelial cells, primary tumours, and different immune cells were also analysed. The biomarkers were ranked according to: (1) detection of haematoxylin/eosin positive nodes, (2) detection of Dukes' A and B patients, who developed metastases during a 54 months follow-up period and (3) identification of patients with Dukes' C and D tumours using the highest value of control nodes as cutoff. The following properties appear to be of importance; (a) no expression in immune cells, (b) relatively high and constant expression in tumour tissue irrespective of Dukes' stage and (c) no or weak downregulation in tumours compared to normal tissue. CEA fulfilled these criteria best, followed by CK20 and MUC2.
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| 4. |
- Ohlsson, Lina, et al.
(författare)
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Detection of Tumor Cells in Lymph Nodes of Colon Cancer Patients Using Real-Time Quantitative Reverse Transcription-Polymerase Chain Reaction
- 2009
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Ingår i: Colorectal Cancer. - NEW YORK : Springer Netherlands. - 9781402095443 - 9781402095450 ; , s. 257-268
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Colorectal cancer is ranked third in worldwide incidence for women and fourth for men representing ͌ 9% of the world cancer or approximately 1 million new cases for 2002 (Parkin et al., 2005). Two thirds of colorectal cancers are located in the colon and one third in the rectum. At diagnosis approximately one third of all patients with colorectal cancer has lymph node positive disease, one third has lymph node-negative disease, and one third has distant metas-tases (Benson et al., 2004). The principal curative treatment for colorectal cancer is surgery. Adjuvant chemotherapy given to lymph node positive colon cancer patients has been shown to increase the survival rate (Haydon, 2003). In rectal cancer patients preoperative irradiation therapy is given to reduce local recurrences and has also been shown to improve survival (Folkesson et al., 2005). Still with these improved treatment modalities only approximately half the number of patients will survive for 5 years. For example, Swedish results for the time period 1995–1999 show a 5-years relative survival of ≈ 57% for both genders (Birgisson et al., 2005).Tumor stage, based on histopathologi-cal examination of the resected specimen, and perioperative findings predict survival. Relative 5-year survival in Dukes' A (T1-2N0M0, Stage I) is 90–95%, Dukes' B (T3-4N0M0, Stage II) 60–80%, Dukes' C (anyTN1-2M0, Stage III) 40–60% and Dukes' D (anyTN0-2M1, Stage IV) < 5% (Staib et al., 2002). Besides distant metas-tases the most important prognostic indicator is the status of the regional lymphatic field showing presence or absence of tumor cells in regional lymph nodes. Given the importance of correctly identifying Dukes' C patients, i.e., patients with lymph node involvement who are eligible for chemotherapy, we have focused on improving the methods for detecting disseminated tumor cells in regional lymph nodes.
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