R. Palmqvist et al., SYSTEMATIC HETEROGENEITY AND PROGNOSTIC-SIGNIFICANCE OF CELL-PROLIFERATION IN COLORECTAL-CANCER, British Journal of Cancer, 77(6), 1998, pp. 917-925
The prognosis of colorectal cancer has not significantly changed durin
g the last 30 years. While evaluation of tumour cell proliferation may
provide prognostic information, results obtained so far have been con
tradictory. Heterogeneity in tumour cell proliferation may explain the
se contradictions. With in vivo injection of iododeoxyuridine (IdUrd),
estimation of labelling index (LI), S-phase transit time (T-s) and po
tential doubling time (T-pot) may be performed from a single sample. A
total of 109 colorectal cancers were studied after in vivo injection
of IdUrd before surgical removal. From each cancer, four to eight samp
les were processed for both flow cytometrical (FCM) and immunohistoche
mical (IHC) visualization of IdUrd incorporation. LI/IHC was morphomet
rically quantified at both the luminal border and the invasive margin
of these tumours. LI was significantly higher at the luminal border co
mpared with the invasive margin, although they were correlated with ea
ch other. Using combined IMC and FCM methods, rapidly growing colorect
al cancers (high LI and/or low T-pot) showed an increased survival (si
gnificant for LI at the invasive margin and for T-pot at both the inva
sive margin and the luminal border) in the entire unselected material
and for radically removed Dukes' B tumours. FCM data alone did not dis
criminate for survival, with the exception of T-s in diploid and radic
ally removed Dukes' B tumours.