Abstract：
BACKGROUND: For clinically low-risk stage III colorectal cancer, the decision on cycles of adjuvant chemotherapy after surgery is disputed. The present study investigates the use of additional biomarkers of ploidy and stroma-ratio(PS) to stratify patients with low-risk stage III colorectal cancer, providing a basis for individualized treatment in the future.
METHODS: This study retrospectively enrolled 198 patients with clinical-low-risk stage III colorectal cancer (T1-3N1M0) and analyzed the DNA ploidy and stroma ratio of FFPE tumor tissues. The patients were divided into PS-low-risk group (Diploidy or Low-stroma) and PS-high-risk group (Non-diploid and High-stroma). For survival analyses, Kaplan-Meier and Cox regression models were used.
RESULTS: The results showed that the 5-year DFS of the PS-high-risk group was significantly lower than that in the PS-low-risk group (78.6 vs. 91.2%, HR = 2.606 [95% CI: 1.011-6.717], P = 0.039). Besides, in the PS-low-risk group, the 5 year OS (98.2 vs. 86.7%, P = 0.022; HR = 5.762 [95% CI: 1.281-25.920]) and DFS (95.6, vs 79.9%, P = 0.019; HR = 3.7 [95% CI: 1.24-11.04]) of patients received adjuvant chemotherapy for > 3 months were significantly higher than those received adjuvant chemotherapy for < 3 months. We also found that the PS could stratify the prognosis of patients with dMMR tumors. The 5-year OS (96.3 vs 71.4%, P = 0.037) and DFS (92.6 vs 57.1%, P = 0.015) were higher in the PS-low-risk dMMR patients than those in the PS-high-risk dMMR patients.
CONCLUSIONS: In this study, we found that PS can predict the prognosis of patients with stage III low-risk CRC. Besides, it may guide the decision on postoperative adjuvant chemotherapy.
METHODS: This study retrospectively enrolled 198 patients with clinical-low-risk stage III colorectal cancer (T1-3N1M0) and analyzed the DNA ploidy and stroma ratio of FFPE tumor tissues. The patients were divided into PS-low-risk group (Diploidy or Low-stroma) and PS-high-risk group (Non-diploid and High-stroma). For survival analyses, Kaplan-Meier and Cox regression models were used.
RESULTS: The results showed that the 5-year DFS of the PS-high-risk group was significantly lower than that in the PS-low-risk group (78.6 vs. 91.2%, HR = 2.606 [95% CI: 1.011-6.717], P = 0.039). Besides, in the PS-low-risk group, the 5 year OS (98.2 vs. 86.7%, P = 0.022; HR = 5.762 [95% CI: 1.281-25.920]) and DFS (95.6, vs 79.9%, P = 0.019; HR = 3.7 [95% CI: 1.24-11.04]) of patients received adjuvant chemotherapy for > 3 months were significantly higher than those received adjuvant chemotherapy for < 3 months. We also found that the PS could stratify the prognosis of patients with dMMR tumors. The 5-year OS (96.3 vs 71.4%, P = 0.037) and DFS (92.6 vs 57.1%, P = 0.015) were higher in the PS-low-risk dMMR patients than those in the PS-high-risk dMMR patients.
CONCLUSIONS: In this study, we found that PS can predict the prognosis of patients with stage III low-risk CRC. Besides, it may guide the decision on postoperative adjuvant chemotherapy.
摘要：
背景：对于临床上低风险的III期结直肠癌，手术后辅助化疗周期的决定存在争议.本研究调查了使用其他倍性和基质比（PS）生物标志物对低风险III期结直肠癌患者进行分层，为今后的个体化治疗提供依据。
方法：本研究回顾性纳入198例临床低危III期结直肠癌（T1-3N1M0）患者，并分析了FFPE肿瘤组织的DNA倍体和基质比。将患者分为PS低风险组（二倍体或低基质）和PS高风险组（非二倍体和高基质）。对于生存分析，使用Kaplan-Meier和Cox回归模型。
结果：结果显示，PS高危组的5年DFS明显低于PS低危组（78.6vs.91.2%,HR=2.606[95%CI：1.011-6.717]，P=0.039)。此外,在PS低风险组中，5年OS(98.2vs.86.7%,P=0.022；HR=5.762[95%CI：1.281-25.920]）和DFS（95.6，vs79.9％，P=0.019；HR=3.7[95%CI：1.24-11.04])>3个月接受辅助化疗的患者明显高于<3个月接受辅助化疗的患者。我们还发现PS可以对dMMR肿瘤患者的预后进行分层。5年OS（96.3vs71.4%，P=0.037）和DFS（92.6vs57.1％，PS低危dMMR患者的P=0.015）高于PS高危dMMR患者。
结论：在这项研究中，我们发现PS可以预测III期低危CRC患者的预后.此外,它可以指导术后辅助化疗的决定。
方法：本研究回顾性纳入198例临床低危III期结直肠癌（T1-3N1M0）患者，并分析了FFPE肿瘤组织的DNA倍体和基质比。将患者分为PS低风险组（二倍体或低基质）和PS高风险组（非二倍体和高基质）。对于生存分析，使用Kaplan-Meier和Cox回归模型。
结果：结果显示，PS高危组的5年DFS明显低于PS低危组（78.6vs.91.2%,HR=2.606[95%CI：1.011-6.717]，P=0.039)。此外,在PS低风险组中，5年OS(98.2vs.86.7%,P=0.022；HR=5.762[95%CI：1.281-25.920]）和DFS（95.6，vs79.9％，P=0.019；HR=3.7[95%CI：1.24-11.04])>3个月接受辅助化疗的患者明显高于<3个月接受辅助化疗的患者。我们还发现PS可以对dMMR肿瘤患者的预后进行分层。5年OS（96.3vs71.4%，P=0.037）和DFS（92.6vs57.1％，PS低危dMMR患者的P=0.015）高于PS高危dMMR患者。
结论：在这项研究中，我们发现PS可以预测III期低危CRC患者的预后.此外,它可以指导术后辅助化疗的决定。
