Influence of the c-erb B-2, nm23, bcl-2 and p53 protein markers on colorectal cancer.

Background/aims: Under stringent intra-laboratory conditions we evaluated the relationship between the expression of four protein markers and clinicopathologic characteristics of colorectal tumors.

Methods: 124 patients with colorectal cancer from 1999 to 2002 were assessed.

Results: The expression of cerb B-2, nm23 and p53 was mostly determined in tumors located in the rectum. However, about 20% of the rectal lesions had bcl-2 expression. p53 and c-erb B-2 expression was significantly demonstrated in the lesions with vascular and lymph node involvement. However, the difference between the markers and staging was not statistically significant (p=0.388, p=0.301). Cerb B-2 and p53 were more frequently expressed in the patients with large tumors (more than 5 cm) with moderate and poor differentiation grade. About half of the tumors expressing c- erb B- 2 and p53 had vascular invasion and more than 70% had N1 and N2 lymphatic invasion as well. In the patients with tumors expressing c-erb B-2 and p53, recurrences often occurred and both disease-free survival (DFS) and overall survival (OS) in the first two years after surgery were shorter than of the patients with tumors expressing nm23 and bcl-2.

Conclusion: In this study, c-erb B-2 and p53 were frequently expressed in the Astler- Coller stage C large tumors located in the rectum and a high degree of vascular and lymphatic invasion was observed. In the patients with tumors expressing c-erb B-2 and p53, recurrences were determined more frequently and DFS and OS were shorter than in patients with tumors expressing nm23 and bcl-2. Thus, two different protein markers should be taken into consideration when evaluating the clinical outcome of patients with colorectal cancer.