Skip to main content
SpringerLink
Log in

Prognostic Factors in Colorectal Cancer

  • Chapter
Gastrointestinal Pathology

Part of the book series: Current Topics in Pathology ((CT PATHOLOGY,volume 81))

Abstract

This account will describe the role of the histopathologist in the management of patients with colorectal cancer. The contributions of the pathologist fall into three areas: the interpretation of biopsies, particularly of the rectum, the management of early cancer and the reporting of surgical specimens of advanced rectal cancer. Information provided by the pathologist may not only determine the likely prognosis but also demonstrate the need for further treatment. Conventional methods of pathological examination do have their limitations. New techniques may provide important insight into the biological behaviour of malignant cells. This review will include a critical account of the value of immunohistochemistry, molecular biology and flow cytometry.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Alexander P (1983) Dormant metastases - studies in experimental animals. J Pathol 141: 379–383

    Article  PubMed  CAS  Google Scholar 

  • Arends JW, Wiggers T, Thijs CT, Verstijnen C, Swaen GJV, Bosman FT (1984a) The value of secretory component (SC) immunoreactivity in diagnosis and prognosis of colorectal carcinomas. Am J Clin Pathol 82:267–274

    PubMed  CAS  Google Scholar 

  • Arends JW, Wiggers T, Verstijnen C, Hilgers J, Bosman FT (1984b) Gastrointestinal cancer-associated antigen (GICA) immunoreactivity in colorectal carcinoma in relation to patient survival. Int J Cancer 34:193–196

    Article  PubMed  CAS  Google Scholar 

  • Arends JW, Bosman FT, Hilgers J (1985) Tissue antigens in large bowel carcinoma. Biochim Biophys Acta 780:1–19

    PubMed  CAS  Google Scholar 

  • Armitage NC, Robins RA, Evans DF, Turner DR, Baldwin RW, Hardcastle JD (1985) The influence of tumour cell DNA abnormalities on survival in colorectal cancer. Br J Surg 72:828–830

    Article  PubMed  CAS  Google Scholar 

  • Banner BG, Tomas-De La Vega JE, Roseman DL, Coon JS (1985) Should flow cytometric DNA analysis precede definitive surgery for colon carcinoma? Ann Surg 202:740–744

    Article  PubMed  CAS  Google Scholar 

  • Bodmer WF, Bailey CJ, Bodmer J et al. (1987) Localization of the gene for familial adenomatous polyposis on chromosome 5. Nature 328:614–616

    Article  PubMed  CAS  Google Scholar 

  • Bos JL, Fearon ER, Hamilton SR, Verlaan-de Vries M, Boom JH van, Eb AJ van der, Vogelstein B (1987) Prevalence of ras gene mutation in human colorectal cancers. Nature 327:293–297

    Article  PubMed  CAS  Google Scholar 

  • Calabretta B, Kaczmarek L, Ming P-ML, Au F, Ming S-C (1985) Expression of c-myc and other cell cycle-dependent genes in human colon neoplasia. Cancer Res 45:6000–6004

    PubMed  CAS  Google Scholar 

  • Carlon CA, Fabris G, Arslan-Pagnini C, Pluchinotta AM (1984) Prognostic correlations of operable carcinoma of the rectum. Dis Colon Rectum 28:47–50

    Article  Google Scholar 

  • Chan KW, Boey J, Wong SKC (1985) A method of reporting radial invasion and surgical clearance of rectal carcinoma. Histopathology 9:1319–1327

    Article  PubMed  CAS  Google Scholar 

  • Cox DR (1972) Regression models and life tables (with discussion). J R Stat Soc B 34:187–200

    Google Scholar 

  • Csiba A, Whitwell HL, Moore M (1984) Distribution of histocompatibility and leucocyte differentiation antigens in normal human colon and in benign and malignant colonic neoplasms. Br J Cancer 50:699–709

    Article  PubMed  CAS  Google Scholar 

  • Dukes CE, Bussey HJR (1958) The spread of rectal cancer and its effect on prognosis. Br J Cancer 12:309–320

    Article  PubMed  CAS  Google Scholar 

  • Ebert EC, Roberts AI, O’Connell SM, Robertson FM, Nagase H (1987) Characterization of an immunosuppressive factor derived from colon cancer cells. J Immunol 138:2161–2168

    PubMed  CAS  Google Scholar 

  • Erisman MD, Rothberg PG, Diehl RE, Morse CC, Spandorfer JM, Astrin SM (1985) Deregulation of c-myc gene expression in human colon carcinoma is not accompanied by amplification or rearrangement of the gene. Mol Cell Biol 5:1969–1976

    PubMed  CAS  Google Scholar 

  • Fearon ER, Hamilton SR, Vogelstein B (1987) Clonal analysis of human colorectal tumors. Science 238:193–196

    Article  PubMed  CAS  Google Scholar 

  • Finan PJ, Quirke P, Dixon MF, Dyson DED, Giles GR, Bird CC (1986) Is DNA aneuploidy a good prognostic indicator in patients with advanced colorectal cancer? Br J Cancer 54:327–330

    Article  PubMed  CAS  Google Scholar 

  • Finlay IG, McArdle CS (1986) Occult hepatic metastases in colorectal carcinoma. Br J Surg 73:732–735

    Article  PubMed  CAS  Google Scholar 

  • Forrester K, Almoguera C, Han K, Grizzle WE, Perucho M (1987) Detection of high incidence of K-ras oncogenes during human colon tumorigenesis. Nature 327:298–303

    Article  PubMed  CAS  Google Scholar 

  • Forster SJ, Talbot IC, Critçhley DR (1984) Laminin and fibronectin in rectal adenocarcinoma: relationship to tumour grade, stage and metastasis. Br J Cancer 50:51–61

    Article  PubMed  CAS  Google Scholar 

  • Gallick GE, Kurzrock R, Kloetzer WS, Arlinhaus RB, Guttermann JU (1985) Expression of p21 ras in fresh primary and metastatic human colorectal tumours. Proc Natl Acad Sci 82:1795–1798

    Article  PubMed  CAS  Google Scholar 

  • Gelister JSK, Jass JR, Mahmoud M, Gaffney PJ, Boulos PB (1987) Role of urokinase in colorectal neoplasia. Br J Surg 74:460–463

    Article  PubMed  CAS  Google Scholar 

  • Ghosh AK, Moore M, Street AJ, Howat JMT, Schofield PF (1986) Expression of HLA-D subregion products on human colorectal carcinoma. Int J Cancer 38:459–464

    Article  PubMed  CAS  Google Scholar 

  • Goh HS, Jass JR, Atkin WS, Cuzick J, Northover JMA (1987) Value of flow cytometric determination of ploidy as a guide to prognosis in operable rectal cancer: a multivariate analysis. Int J Colorect Dis 2:17–21

    Article  CAS  Google Scholar 

  • Hamada Y, Yamamura M, Hioki K, Yamamoto M, Nagura H, Watanabe K (1985) Immunohistochemical study of carcinomabryonic antigen in patients with colorectal cancer. Correlation with plasma carcinoembryonic antigen levels. Cancer 55:136–141

    Article  PubMed  CAS  Google Scholar 

  • Hart IR, Fidler IJ (1981) The implications of tumor heterogeneity for studies on the biology and therapy of cancer metastases. Biochim Biophys Acta 651:37–50

    PubMed  CAS  Google Scholar 

  • Isaacson P (1982) Immunoperoxidase study of the secretory immunoglobulin system in colonic neoplasia. J Clin Pathol 35:14–25

    Article  PubMed  CAS  Google Scholar 

  • Jass JR (1986) Lymphocytic infiltration and survival in rectal cancer. J Clin Pathol 39:585–589

    Article  PubMed  CAS  Google Scholar 

  • Jass JR, Atkin WS, Cuzick J, Bussey HJR, Morson BC, Northover JMA, Todd IP (1986) The grading of rectal cancer: historical perspectives and a multivariate analysis of 447 cases. Histopathology 10:437–59

    Article  PubMed  CAS  Google Scholar 

  • Jass JR, Love SB, Northover JMA (1987) A new prognostic classification of rectal cancer. Lancet 1:1303–1306

    Article  PubMed  CAS  Google Scholar 

  • Kerr IB, Lee FD, Quintanilla M, Balmain A (1985) Immunocytochemical demonstration of p21 ras family product in normal mucosa and in premalignant and malignant tumours of the colorectum. Br J Cancer 52:695–700

    Article  PubMed  CAS  Google Scholar 

  • Kerr IB, Spandidos DA, Finlay IG, Lee FD, McArdle CS (1986) The relation of the ras family oncogene expression to conventional staging criteria and clinical outcome in colorectal carcinoma. Br J Cancer 53:231–235

    Article  PubMed  CAS  Google Scholar 

  • Knudsen JB, Nilsson T, Sprechler M, Johansen A, Christensen N (1983) Venous and nerve invasion as prognostic factors in postoperative survival of patients with resectable cancer of the rectum. Dis Colon Rectum 26:613–617

    Article  PubMed  CAS  Google Scholar 

  • Knudson AG (1971) Mutation and cancer: statistical study of retinoblastoma. Proc Natl Acad Sci USA 68:820–823

    Article  PubMed  Google Scholar 

  • Kokal W, Sheibani K, Terz J, Harada R (1986) Tumor DNA content in the prognosis of colorectal carcinoma. JAMA 255:3123–3127

    Article  PubMed  CAS  Google Scholar 

  • Kronborg O, Hage E, Fenger C, Deichgraeber E (1986) Do synchronous adenomas influence prognosis after radical surgery for colorectal cancer? A prospective study. Int J Colorect Dis 1:99–103

    Article  CAS  Google Scholar 

  • Melamed MR, Enker WE, Banner P, Janov AJ, Kessler G, Darzynkiewicz Z (1986) Flow cytometry of colorectal carcinoma with three-year follow-up. Dis Colon Rectum 29:184–186

    Article  PubMed  CAS  Google Scholar 

  • Monnat M, Tardy S, Saraga P, Diggelmann H, Costa J (1987) Prognostic implications of expresion of the cellular genes myc, fos, Ha-ras and Ki-ras in colon carcinoma. Int J Cancer 40:293–299

    Article  PubMed  CAS  Google Scholar 

  • Morson BC (1966) Factors influencing the prognosis of early cancer of the rectum. Proc R Soc Med 59:607–608

    PubMed  CAS  Google Scholar 

  • Muleris M, Salmon RJ, Zafrani B, Girodet J, Dutrillaux B (1985) Consistent deficiences of chromosome 18 and of the short arm of chromosome 17 in eleven cases of human large bowel cancer: a possible recessive determinism. Ann Genet 28:206–213

    PubMed  CAS  Google Scholar 

  • Quirke P, Durdey P, Dixon MF, Williams NS (1986) Local recurrence of rectal adenocarcinoma due to inadequate surgical resection. Histopathological study of lateral tumour spread and surgical excision. Lancet 11:996–999

    Article  Google Scholar 

  • Quirke P, Dixon MF, Clayden AD, Durdey P, Dyson JED, Williams NS, Bird CC (1987) Prognostic significance of DNA aneuploidy and cell proliferation in rectal adenocarcinomas. J Pathol 151:285–291

    Article  PubMed  CAS  Google Scholar 

  • Redman BG, Pazdur R (1987) Colonic small cell undifferentiated carcinoma: a distinct pathological diagnosis with therapeutic implications. Am J Gastroenterol 82:382–385

    PubMed  CAS  Google Scholar 

  • Rognum TO, Elgjo K, Brandtzaeg P, Ørjasaeter H, Bergan A (1982) Plasma carcinoembryonic antigen concentrations and immunohistochemical patterns of epithelial marker antigens in patients with large bowel carcinoma. J Clin Pathol 35:922–933

    Article  PubMed  CAS  Google Scholar 

  • Rognum TO, Brandtzaeg P, Thorud E (1983) Is heterogeneous expression of HLA-DR antigens and CEA along with DNA-profile variations evidence of phenotypic instability and clonal proliferation in human large bowel carcinomas? Br J Cancer 48:543–551

    Article  PubMed  CAS  Google Scholar 

  • Rothberg PG, Spandorfer JM, Erisman MD, Staroscik RN, Sears HF, Petersen RO, Astrin SM (1985) Evidence that c-myc expression defines two genetically distinct forms of colorectal adenocarcinoma. Br J Cancer 52:629–632

    Article  PubMed  CAS  Google Scholar 

  • Sanderson AR, Beverley PCL (1983) Interferon, ß2 microglobulin and immunoselection in the pathway to malignancy. Immunol Today 4:211–213

    Article  CAS  Google Scholar 

  • Sasaki O, Atkin WS, Jass JR (1987) Mucinous carcinoma of the rectum. Histopathology 11:259–272

    Article  PubMed  CAS  Google Scholar 

  • Schoentag R, Primus FJ, Kuhns W(1987) ABH and Lewis blood group expression in colorectal carcinoma. Cancer Res 47:1695–1700

    PubMed  CAS  Google Scholar 

  • Scott NA, Grande JP, Weiland LH, Pemberton JH, Beart RW, Lieber MM (1987a) Flow cytometric DNA patterns from colorectal cancers - how reproducible are they? Mayo Clin Proc 62:331–337

    PubMed  CAS  Google Scholar 

  • Scott NA, Rainwater LM, Wicand HS, Wciland LH, Pemberton JH, Beart RW, Licbncr MM (1987b) The relative prognostic value of flow cytometric DNA analysis and conventional clinicopathologic criteria in patients with operable rectal carcinoma. Dis Colon Rectum 30:513–520

    Article  PubMed  CAS  Google Scholar 

  • Selby WS, Janossy G, Mason DY, Jewell DP (1983) Expression of HLA-DR antigens by colonic epithelium in inflammatory bowel disease. Clin Exp 53:614–618

    CAS  Google Scholar 

  • Solomon E, Voss R, Hall V et al. (1987) Chromosome 5 allele loss in human colorectal carcinomas. Nature 328:616–619

    Article  PubMed  CAS  Google Scholar 

  • Spandidos DA, Kerr IB (1984) Elevated expression of the human ras oncogene family in premalignant and malignant tumours of the colorectum. Br J Cancer 49:681–688

    Article  PubMed  CAS  Google Scholar 

  • Spencer J, Finn T, Isaacson PG (1986) Expression of HLA-DR antigens on epithelium associated with lymphoid tissue in the human gastrointestinal tract. Gut 27:153–157

    Article  PubMed  CAS  Google Scholar 

  • Sporn MB, Todaro GJ (1980) Autocrine secretion and malignant transformation of cells. N Engl J Med 303:878–880

    Article  PubMed  CAS  Google Scholar 

  • Stewart J, Evan G, Watson J, Sikora K (1986) Detection of the c-myc oncogene product in colonic polyps and carcinomas. Br J Cancer 53:1–6

    Article  PubMed  CAS  Google Scholar 

  • Svennevig JL, Lunde OC, Holter J, Bjorgsvik D (1984) Lymphoid infiltration and prognosis in colorectal carcinoma. Br J Cancer 49:375–377

    Article  PubMed  CAS  Google Scholar 

  • Thomas GDH, Dixon MF, Smeeton NC, Williams NS (1983) Observation variation in the histological grading of rectal carcinoma. J Clin Pathol 36:385–91

    Article  PubMed  CAS  Google Scholar 

  • Tribukait B, Hammarberg C, Rubio C (1983) Ploidy and proliferation patterns in colorectal adenocarcinomas related to Dukes’ classification and to histopathological differentiation: a flow cytometric DNA study. Acta Pathol Microbiol Scand [A]91:89–95

    CAS  Google Scholar 

  • van den Ingh HF, Ruiter DJ, Griffioen G, Muijen GNP van, Ferrone S (1987) HLA antigens in colorectal tumours — low expression of HLA class I antigens in mucinous colorectal carcinomas. Br J Cancer 55:125–130

    Article  PubMed  Google Scholar 

  • Weiss J, Holmes JC, Ward PM (1983) Do metastases arise from pre-existing subpopulations of cancer cells? Br J Cancer 47:81–89

    Article  PubMed  CAS  Google Scholar 

  • Whiteway J, Nicholls RJ, Morson BC (1985) The role of surgical local excision in the treatment of rectal cancer. Br J Surg 72:694–687

    Article  PubMed  CAS  Google Scholar 

  • Wolley RC, Screiber K, Koss LG, Karas LG, Sherman A (1982) DNA distribution in human colon carcinomas and its relationship to clinical behavior. J Natl Cancer Inst 69:15–22

    PubMed  CAS  Google Scholar 

  • Wood WQ, Wilkie DPD (1933) Carcinoma of the rectum. An anatomico-pathological study. Ed Med J 40:321–43

    Google Scholar 

  • Zhou X-G, Yu B-M, Shen Y-X (1983) Surgical treatment and late results in 1226 cases of colorectal cancer. Dis Colon Rectum 26:250–256

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. J. R. Jass
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Pathology, College of Medicine, University of Wales, CF4 4XN, Cardiff, UK

    Geraint T. Williams B. Sc., M. D., M. R. C. P., M. R. C. Path.,

Rights and permissions

Reprints and permissions

Copyright information

© 1990 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Jass, J.R. (1990). Prognostic Factors in Colorectal Cancer. In: Williams, G.T. (eds) Gastrointestinal Pathology. Current Topics in Pathology, vol 81. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-74662-8_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-74662-8_14

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-74664-2

  • Online ISBN: 978-3-642-74662-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation