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A Journal on Surgery

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Minerva Chirurgica 2000 March;55(3):99-104

language: Italian

Characterisation and prognostic value of colorectal adenomas using moleculargenetic markers

Di Stefano A., Fisichella P., Catanuto G., Di Blasi M., La Greca G., Grasso G., Russello D.


Aim. The study analyses the expression of DNA-ploidy, ki-67, PCNA and p-53 and their role as potential markers of the development of colorectal adenomas. Methods. 34 adenomas of the large intestine were analysed using endoscopic exeresis in 15 males and 13 females with a mean age of 64 years (range 42-80). Flow cytometric analysis was carried out to calculate the DNA-index and immunohistochemical tests were used to evaluate ki-67, PCNA and p-53. Statistical analysis was based on c2 test and Student's ''t''-test. Results. The DNA index was not statistically correlated with the histotype and grading. Ki-67 was highly positive in 5 adenomas, 2 aneuploids and 3 diploids, but did not show a clear relationship with other growth parameters. On the contrary, p-53 was statistically correlated with the more advanced degenerative state of adenomas, being pathological in 6 cases (30%), all with marked aneuploidy (p<0.02) and severe dysplasia (p<0.004). PCNA, which was also pathological (>40%) in 4 (23.5%) aneuploid adenomas with severe dysplasia (2 villous and 2 tubulo-villous), appeared to be significantly correlated with the DNA index (p<0.005), showing a proliferative index of exceptional clinical importance. Conclusions. The results of this study show that p-53 and PCNA are two parameters that contribute to the definition of the degenerative risk and allow patients to be selected for constant monitoring, although additional follow-up data are essential to enable the clinical verification of these results.

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