目的:评估三种新型生物标志物的预后价值,DNA倍性,间质肿瘤分数,和核型分析,在II期结肠癌中寻求更准确的分层。
方法:本研究共纳入417例具有完整随访信息的患者,并将其分为三个临床风险组。进行IHC检查MSI状态。DNA倍性,使用自动数字成像系统估计基质和核型。Kaplan-Meier存活曲线,Cox比例风险回归模型,并进行相关分析以处理我们的数据。
结果:在整个II期结肠癌队列中,在单变量分析中,核型和DNA倍体是OS的重要预后因素。核型和DNA倍性的结合表明了优越的OS和DFS。低基质和高基质患者之间的差异不显着。在多变量分析中,证明核型以及核型和DNA倍性的组合是OS的主要促成因素。在低风险组中,我们发现,在单变量和多变量中,核型和DNA倍体的组合作为独立的预后因素具有统计学意义,而在高危人群中,核型。
结论:我们的研究已证明核型以及DNA倍性和核型的组合是独立的预后指标,从而将核型分析作为预测因子的应用从高风险II期结肠癌扩展到整体风险.
OBJECTIVE: To assess the prognostic value of three novel biomarkers, DNA
ploidy, stroma-tumor fraction, and nucleotyping, seeking for more accurate stratification in stage II colon cancer.
METHODS: A total of 417 patients with complete follow up information were enrolled in this study and divided into three clinical risk groups. IHC was performed to examine MSI status. DNA
ploidy, stroma and nucleotyping were estimated using automated digital imaging system. Kaplan-Meier survival curves, Cox proportional hazards regression models, and correlation analyses were carried out to process our data.
RESULTS: In the whole cohort of stage II colon cancer, nucleotyping and DNA
ploidy were significant prognostic factors on OS in univariate analyses. The combination of nucleotyping and DNA
ploidy signified superior OS and DFS. Difference was not significant between low-stroma and high-stroma patients. In multivariable analyses, nucleotyping and the combination of nucleotyping and DNA
ploidy were proven the dominant contributory factors for OS. In the low-risk group, we found the combination of nucleotyping and DNA ploidy as the independent prognostic factor statistically significant in both univariate and multivariable, while in the high-risk group, the nucleotyping.
CONCLUSIONS: Our study has proven nucleotyping and the combination of DNA ploidy and nucleotyping as independent prognostic indicators, thus expanding the application of nucleotyping as a predictor from high risk stage II colon cancer to whole risks.