Tumor Biology

, Volume 36, Issue 8, pp 6579–6584 | Cite as

Genetic dissimilarity between primary colorectal carcinomas and their lymph node metastases: ploidy, p53, bcl-2, and c-myc expression—a pilot study

  • Khaled Refaat Zalata
  • Mohamed Farouk Elshal
  • Abd AlRahman Mohammad Foda
  • Ashraf Shoma
Research Article


The current paradigm of metastasis proposes that rare cells within primary tumors acquire metastatic capability via sequential mutations, suggesting that metastases are genetically dissimilar from their primary tumors. This study investigated the changes in the level of expression of a well-defined panel of cell proliferation, differentiation, and apoptosis markers between the primary colorectal cancer (CRC) and the corresponding synchronous lymph node (LN) metastasis from the same patients. DNA flow cytometry and immunostaining of p53, bcl-2, and c-myc were carried out on 36 cases of CRC radical resection specimens with their corresponding LN metastases. There was very low probability that the histological patterns of primary tumors and LN metastases are independent (p < 0.001). Metastatic tumors were significantly more diffusely positive for p53 than the primary tumors (p < 0.001). Conversely, primary tumors were significantly more diffusely positive for c-myc than metastatic tumors (p = 0.011). No significant difference was found between the LNs and the primary tumors in bcl-2 positivity (p = 0.538) and DNA aneuploidy (p = 0.35), with a tendency towards negative bcl-2 and less aneuploidy in LN metastases than primary tumors. In conclusion, LN metastatic colorectal carcinomas have a tendency of being less differentiated, with a higher incidence of diffuse p53 staining, lower incidence of bcl-2 staining, and less aneuploidy in comparison to their primary counterparts suggesting a more aggressive biological behavior, which could indicate the necessity for more aggressive adjuvant therapy.


Colorectal LN metastasis Ploidy c-Myc p53 Bcl-2 


Compliance with ethical standards

This study is approved by local ethical committee.

Conflicts of interest



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Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2015

Authors and Affiliations

  • Khaled Refaat Zalata
    • 1
  • Mohamed Farouk Elshal
    • 2
  • Abd AlRahman Mohammad Foda
    • 1
  • Ashraf Shoma
    • 3
  1. 1.Pathology Department, Faculty of MedicineMansoura UniversityMansouraEgypt
  2. 2.Molecular Biology Department, Genetic Engineering and Biotechnology InstituteSadat City UniversitySadat CityEgypt
  3. 3.Surgery Department, Faculty of MedicineMansoura UniversityMansouraEgypt

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