ABSTRACT
AIM: Our aim was to determine if the lymph node ratio would predict overall survival and disease-free survival in Dukes C colorectal cancer in a district general hospital setting in the UK. METHOD: Fifty-six patients were analysed from a prospectively maintained colorectal cancer database. The lymph node ratio was defined as the number of positive lymph nodes divided by the total number of nodes harvested. Comparison was made between the lymph node ratio,TNM nodal status and number of positive lymph nodes by the Kaplan-Meier method. An analysis of covariates was performed by a Cox proportional hazard regression analysis. RESULTS: A lymph node ratio of > 0.25 is prognostically significant for overall survival (P = 0.03) and disease-free survival (P = 0.0003). The lymph node ratio was the strongest covariate in the multivariate regression analysis for recurrence (P = 0.003). CONCLUSION: The lymph node ratio may help clinicians determine which patients have a more aggressive tumour biology and direct appropriate more aggressive chemotherapy regimes towards these patients.
Subject(s)
Colorectal Neoplasms/mortality , Colorectal Neoplasms/pathology , Lymph Nodes/pathology , Lymphatic Metastasis/pathology , Adenocarcinoma/pathology , Adult , Aged , Aged, 80 and over , Colorectal Neoplasms/drug therapy , Databases, Factual , Humans , Middle Aged , Neoplasm Staging , Prognosis , Proportional Hazards Models , Retrospective StudiesABSTRACT
The purpose of this study was to determine if Protein Kinase C alpha (PKC alpha) is altered in expression or localisation in normal breast, ductal carcinoma in situ (DCIS) and invasive ductal carcinoma (IDC). We obtained 14 mixed cases of invasive ductal carcinoma (IDC) and DCIS, 36 pure DCIS cases and 25 cases of normal breast. The sections were stained immunohistochemically for PKC alpha expression. Staining was cytoplasmic. The results showed a progressive reduction in staining intensity from normal breast to invasive ductal carcinoma. The staining pattern was heterogeneous in the cytoplasm of DCIS and IDC, but homogeneous in the cytoplasm of normal breast ductal epithelium. Interestingly, mitotic cells and cells with aberrant nuclear morphology showed increased cytoplasmic staining in DCIS and IDC. PKC alpha activity is altered in dividing or abnormal cells, but overall expression is reduced in IDC. This raises the possibility of an alteration in the subcellular localisation of PKC alpha which may relate to changes in desmosomal adhesive state.
