Prognostic estimation of survival of colorectal cancer patients with the quantitative histochemical assay of G6PDH activity and the multiparameter classification program CLASSIF1

Prognosis of colorectal cancer patients that show similar histopathology ma y vary substantially. An attempt: was made to improve prognosis by the self -learning classification program CLASSIF1, based on automated multiparamete r analysis of quantitative histochemical and clinical parameters of 64 colo rectal carcinomas and adjacent normal mucosae. The histochemical parameters applied were the oxygen-insensitivity assay of glucose-6-phosphate dehydro genase (G6PDH) activity, a valid discriminator between normal and cancerous mucosae, and related parameters CuZn- and Mn-superoxide dismutase (SOD) le vels, and lipid peroxidation (LPO) capacity. Data were processed on the bas is of a postoperative follow-up of minimally 32 and maximally 56 months. CL ASSIF1 selected the parameters oxygen insensitivity of G6PDH activity, CuZn -SOD and Mn-SOD levels, LPO capacity, lymph node metastasis, Dukes' stage, and age for the highest prognostic value. On the basis of these selected pa rameters, GLASSIF1 correctly predicted favorable outcome in 100% of the sur viving patients and fatal outcome in 64% of the deceased patients. G6PDH ac tivity appeared to be the major information carrier for GLASSIF1. On the ba sis of G6PDH activity parameters alone, 96% of the surviving patients and 5 5% of the deceased patients were correctly classified. In comparison, estim ation of prognosis on the basis of Dukes' stage alone resulted in 71% corre ctly classified surviving patients and 61% of patients who died. It is conc luded that the self-learning classification program CLASSIF1, on the basis of: quantitative histochemical and clinical parameters, is the best prognos tic estimator for colon cancer patients yet available. Cytometry (C) 1999 W iley-Liss, Inc.