Colorectal cancer in patients seen at the teaching hospitals of Guadeloupe and Martinique: discrepancies, similarities in clinicopathological features, and p53 status
Tóm tắt
In Guadeloupe and Martinique, two French Overseas Departments, colorectal cancer (CRC) has become an essential public health issue. However, little is known about CRC characteristics and the p53 status in these populations, particularly in Guadeloupe, whereas certification of a cancer registry has been recently validated. This was a descriptive retrospective study of 201 patients who, between 1995 and 2000, underwent surgery for CRC in the Guadeloupe Teaching Hospital (GlpeTH; 83 patients) and in the Martinique Teaching Hospital (MqueTH; 118 patients). The clinicopathological features and the p53 expression, evaluated with immunohistochemistry, were compared at the time of diagnosis. A relationship between these parameters and the p53 expression was also studied. Data were analysed, using the SPSS computer software version 17.0. No statistical difference was found between the two groups of patients regarding age (p = 0.60), percentage of young patients (≤50 years; p = 0.94)), sex (p = 0.47), histological type (p = 0.073) and tumour sites (p = 0.65), although the GlpeTH patients were diagnosed with more distal colon cancers (54.2%) than the Mque TH patients (47.4%). By contrast, a significant difference was found regarding the tumour grade (p < 0.0001), the pTNM stage (p = 0.045) and the pT stage (p < 0.0001). Regarding p53 expression, solely for the MqueTH patients, nuclear expression was associated with pTNM, the percentage of p53 negative tumours increasing with the progression of the pTNM stages (p = 0.029). For the first time, this study reveals discrepancies in clinicopathological features and in the p53 status between the two groups of patients. The GlpeTH patients were diagnosed with more moderated CRCs but with few CRCs at pTNM IV stage. By contrast, the MqueTH patients were diagnosed with more differentiated tumours, but with many more CRCs at pTNM IV stage. This paradox may be due to differences in tumour location (distal vs proximal), multiplicity of the genetic profiles of patients, or patients getting treatment elsewhere. Although our study is limited due to its small size, it emphasizes the originality of our results.
Tài liệu tham khảo
Hawk ET, Linburg PJ, Viner JL: Epidemiology and prevention of colorectal cancer. Surg Clin North Am. 2002, 82: 905-941. 10.1016/S0039-6109(02)00046-4.
Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D: Global cancer statistics. CA Cancer J Clin. 2011, 61: 69-90. 10.3322/caac.20107.
Vogelstein B, Fearon ER, Hamilton SR, Kern SE, Preisinger AC, Leppert M, Nakamura Y, White R, Smits AM, Bos JL: Genetic alterations during colorectal-tumourdevelopment. N Engl J Med. 1988, 319: 525-532. 10.1056/NEJM198809013190901.
Jass JR: Classification of colorectal cancer based on correlation of clinical, morphological and molecular features. Histopathology. 2007, 50: 113-130. 10.1111/j.1365-2559.2006.02549.x.
Levine AJ: p53 the cellular gatekeeper for growth and division. Cell. 1997, 88: 23-331.
Iacopeta B: TP53 Mutation in colorectal cancer. Hum Mutat. 2003, 21: 271-276. 10.1002/humu.10175.
Soussi T: p53 mutations in human cancer: database reassessment and prospects for the next decade. Adv Cancer Res. 2011, 110: 107-139.
Riley T, Sontag E, Chen P, Levine A: Transcriptional control of human p53 regulated gene. Nat Rev Mol Cell biol. 2008, 9: 402-412. 10.1038/nrm2395.
Gannon JV, Greaves R, Iggo R, Lane DP: Activating mutations in p53 produce a common conformational effect: a monoclonal antibody specific for the mutant form. EMBO J. 1990, 9: 1595-1602.
Kerns BJ, Jordan PA, Moore MB, Humphrey PA, Berchuck A, Kohler MF, Bast RC, Iglehart JD, Marks JR: P53 overexpression in formalin-fixed, paraffin-embedded tissue detected by immunohistochemistry. J HistochemCytochem. 1992, 40: 1047-1051.
Dieye M, Plenet J, Fior A, Deloumeaux J, Bhakkan , Macni J, Roué T: La surveillance des cancers dans les Antilles et en Guyane. Institut de Veille Sanitaire (INVS). 2011, 8: 1-10.
Serra D, Chérié-Challine L, Bloch J: Cancer mortality in French West Indies and French metropolitan regions, France, 1983–2002. BEH. 2008, 9: 64-88.
Ngasseu P, Dieye M, Veronique-Baudin J, Draganescu C, Dorival M-J, Ossondo M, Smith-Ravin J, Azaloux H: Colorectal cancer in Martinique: incidence and mortality rates over a period of 20 years. Rev Epidemiol Sante Publique. 2007, 55: 333-338. 10.1016/j.respe.2007.06.001.
Dieye M, Veronique-Baudin J, Draganescu C, Azaloux H: Cancer incidence in Martinique: a model of epidemiological transition. Eur J Cancer Prev. 2007, 16: 95-101.
Keclard L, Romana M, Saint-Martin C: Epidémiology des gènes globines dans le bassin caribéen. La drépanocytose - Regards croisés sur une maladie orpheline. Edited by: Karthala. 2004, 75-91.
Wong R: Proximal tumors are associated with greater mortality in colon cancer. J Gen Intern Med. 2010, 25: 1157-1163. 10.1007/s11606-010-1460-4.
Bossai N, Velten M, Remontet L: Survival of cancer patients in France: a population based study from the association of the French cancer registry (FRANCIM). Eur J Cancer. 2007, 43: 149-156. 10.1016/j.ejca.2006.07.021.
Chevreul K: Colorectal cancer in France. Eur J Health Econ. 2010, 10: S15-S20. 10.1007/s10198-009-0185-y.
Katkoon VR, Jia X, Shnmugam C, Wan W, Meleth S, Bumpers H, Grizzle WE, Manne U: Prognostic significance of p53 codon 73 polymorphism differs with race in colorectal adenocarcinoma. Clin Cancer Res. 2009, 15: 2406-2416. 10.1158/1078-0432.CCR-08-1719.
Polite B, Dignam J, Olopade O: Colorectal cancer model of health disparities: understanding mortality differences in minority populations. J Clin Oncol. 2006, 24: 2179-2187. 10.1200/JCO.2005.05.4775.
Polite B, Dignam J, Olopade O: Colorectal cancer and race: understanding the differences in outcomes between African Americans and Whites. Med Clin N Am. 2005, 89: 771-793. 10.1016/j.mcna.2005.03.001.
Shavers VL: Racial/ethnic variation in the anatomic subsite location of in situ and invasive cancers of the colon. J Natl Med Assoc. 2007, 99: 733-748.
LoConte NK, Williamson A, Gayle A, Weiss J, Leal T, Cetnar J, Mohammed T, Tevaarwerk A, Jones N: Increasing disparity in colorectal cancer incidence and mortality among African Americans and Whites: a state’s Experience. J Gastro intest Oncol. 2011, 2: 85-92.
Chalya PL, Mchembe MD, Mabula JB, Rambau PF, Jaka H, Koy M, Mkongo E, Masalu N: Clinicopathological patterns and challenges of management of colorectal cancer in a resource-limited setting: a Tanzanian experience. World J Surg Oncol. 2013, 11: 2-10.1186/1477-7819-11-2. doi:10.1186/1477-7819-11-88
Lane DP: Cancer p53 guardian of the genome. Nature. 1992, 358: 15-16. 10.1038/358015a0.
Soussi T: p53 alteration in human cancer: more question than answers. Oncogene. 2007, 26: 2145-2156. 10.1038/sj.onc.1210280.
Rambau PF, Odida M, Wabinga H: p53 expression in colorectal carcinoma in relation to histopathological features in Ugandan patients. Afr Health Sci. 2008, 8: 234-238.
Kwon HC, Kim SH, Oh SY, Lee S, Kwon KA, Choi HJ, Park KJ, Kim HJ, Roh MS: Clinicopathological significance of p53, hypoxia-inducible factor 1alpha, and vascular endothelial growth factor expression in colorectal cancer. Anticancer Res. 2010, 30: 4163-4168.
Galizia G, Lieto E, Ferraraccio F, Orditura M, De Vita F, Castellano P, Imperatore V, Romano C, Ciardiello F, Agostini B, Pignatelli C: Determination of molecular marker expression can predict clinical outcome in colon carcinomas. Clin Cancer Res. 2004, 10: 3490-3499. 10.1158/1078-0432.CCR-0960-03.
Lenz H-J, Danenberg KD, Leichman CG, Florentine B, Johnston PG, Groshen S, Zhou L, Xiong YP, Danenberg PV, Leichman LP: p53 and thymidylate synthase expression in untreated stage II colon cancer: association with recurrence, survival and site. Clin Cancer Res. 1998, 4: 1227-1234.
Mane U, Weiss HL, Myers RB, Danner OK, Moron C, Srivastava S, Grizzle WE: Nuclearaccumulation of p53 in colorectal adenocarcinoma: prognostic importance differs with race and location of the tumor. Cancer. 1998, 83: 2456-2457. 10.1002/(SICI)1097-0142(19981215)83:12<2456::AID-CNCR8>3.0.CO;2-5.
Diez M, Medrano M, Muguerza JM, Ramos P, Hernandez P, Villeta R, Martin A, Noguerales F, Ruiz A, Graneli J: Influence of tumor localization on the prognostic value of p53 protein in colorectal adenocarcinomas. Anticancer Res. 2000, 20: 3907-3912.
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