Prognostic valude of Ki-67, TS, p53, bcl-2, EGFR, MLH1 and MSH2 in 107 consecutive colorectal cancer patients.

3694 Background: Bio-pathological studies of colorectal cancer (CRC) have provided informations into pathogenesis, but it is unclear how important these markers are in predicting prognosis and in clinical outcomes. The aim of this study was to evaluate the prognostic value of the expression of Ki-67, TS, p53, bcl-2, EGFR, MLH1 and MSH2 in specimens of CRC.,The bio-markers were immunohistochemically determinated in the primary tumor of 107 consecutive pts who underwent surgery between June 2000 and August 2004. Pt characteristics were: males 69 (64.5%) and females 38 (35.5%); median age 68 (36-87); primary tumor site: right colon 40 (37.4%) and left colon 67 (62.6%); stage I 4 (3.7%), stage II 43 (40.2%), stage III 34 (31.8%) and stage IV 26 (24.3%); adjuvant chemotherapy with 5FU/AF regimen in 51 pts (47.7%); chemotherapy for advanced disease in 29 pts (27.1%). Median follow-up was 17 months (1-48).,No differences in marker expression were detected between right and left colon. The correlation between markers and disease stage, in univariate analysis, was as follows: Ki-67 expression decreased in higher stages: stage I-II mean 72.1%, III 63.3%, IV 65.2%, with statistical significant difference between stage I-II vs III (p=0.032); p53 expression decreased in higher stages: stage I-II mean 55,4% and IV mean 33.9% (p=0.037); negative MLH1 was prevalent in stage I-II vs III-IV (p=0.0125). No significant correlation was observed between expression of TS, EGFR, MSH2 and stage. No correlation was observed between molecular marker expression and relapse free survival (RFS) in stage II-III pts treated with adjuvant 5FU/AF chemotherapy. The evaluation of 77 stage II-III pts showed an association between bcl-2 expression and RFS % of cumulative survival (Kaplan-Meier test): bcl-2 negative = 75.5; bcl-2 intermediate = 81.4; bcl-2 positive = 100. No statistical association was found between p53, TS, EGFR, MLH1, MSH2 expression and RFS in this subgroup of pts, though there was a trend between p53 expression and higher % of RFS cumulative survival.,This study suggests that Ki-67 is inversely correlated with disease stage and apoptotic markers may have a prognostic role in CRC. No significant financial relationships to disclose.