Colorectal cancer in patients seen at the teaching hospitals of Guadeloupe and Martinique: discrepancies, similarities in clinicopathological features, and p53 status

Abstract

BackgroundIn Guadeloupe and Martinique, two French Overseas Departments, colorectal cancer (CRC) has become an essential public health issue. However, little is known about CRC characteristics and the p53 status in these populations, particularly in Guadeloupe, whereas certification of a cancer registry has been recently validated.MethodsThis was a descriptive retrospective study of 201 patients who, between 1995 and 2000, underwent surgery for CRC in the Guadeloupe Teaching Hospital (GlpeTH; 83 patients) and in the Martinique Teaching Hospital (MqueTH; 118 patients). The clinicopathological features and the p53 expression, evaluated with immunohistochemistry, were compared at the time of diagnosis. A relationship between these parameters and the p53 expression was also studied. Data were analysed, using the SPSS computer software version 17.0.ResultsNo statistical difference was found between the two groups of patients regarding age (p = 0.60), percentage of young patients (≤50 years; p = 0.94)), sex (p = 0.47), histological type (p = 0.073) and tumour sites (p = 0.65), although the GlpeTH patients were diagnosed with more distal colon cancers (54.2%) than the Mque TH patients (47.4%). By contrast, a significant difference was found regarding the tumour grade (p < 0.0001), the pTNM stage (p = 0.045) and the pT stage (p < 0.0001). Regarding p53 expression, solely for the MqueTH patients, nuclear expression was associated with pTNM, the percentage of p53 negative tumours increasing with the progression of the pTNM stages (p = 0.029).ConclusionsFor the first time, this study reveals discrepancies in clinicopathological features and in the p53 status between the two groups of patients. The GlpeTH patients were diagnosed with more moderated CRCs but with few CRCs at pTNM IV stage. By contrast, the MqueTH patients were diagnosed with more differentiated tumours, but with many more CRCs at pTNM IV stage. This paradox may be due to differences in tumour location (distal vs proximal), multiplicity of the genetic profiles of patients, or patients getting treatment elsewhere. Although our study is limited due to its small size, it emphasizes the originality of our results.

Inflammatory and Cell Adhesion Protein Markers in Colorectal Cancer in Patients Seen at the Teaching Hospital of Guadeloupe: Role of NF kappaB and P-Selectin

“…Indeed, we proposed that VEGF and VCAM-1 expression may depend of tumour environmental factors [21] distinct from NFκBp65 and HIF-1α. In addition, regarding CRC p53 expression, we recently demonstrate differences between Glpe TH patients and Martinique Teaching hospital patients, as well as metropolitan France and Caucasian patients [16]. Thus, the differential expression of the five markers tested in the present study may be related to the multiplicity of genetic profile of the GlpeTH patients.…”

“…Archival formalin-fixed and paraffin-embedded tumour tissues and normal mucosa, taken 5 centimetres away from the tumour area, were chosen among patients who underwent surgery in the GlpeTH between 1995 and 2000 [16]. None of the patient recruited to the study received chemotherapy or radiotherapy prior tumour resection.…”

“…Nuclei were counterstained with haematoxylin and slides mounted for examination. The following four-grade scoring system, as recently described [16] was used: (0) no reaction; (1 + ) weak reaction; (2 + ) moderate reaction and (3 + ) strong reaction.…”

“…Expression of proteins was assessed by IHC using the Horseradish detection system EnVision kit plus Dual link system-HRP complex and anti-Mouse/Rabbit-HRP (DAKO, Carpinteria, CA, USA) as recently described [16]. The following primary antibodies: rabbit polyclonal antibody raised against HIF-1α (H 2061; dilution 1:50; Santa Cruz Biotechnology, Santa Cruz, CA, USA), rabbit polyclonal antibody against NFκB p65 (sc-109; dilution 1:100; Santa Cruz Biotechnology), mouse monoclonal antibody against VEGF (VG1; dilution 1:25; DAKO), which labels the VEGF-121, VEGF-165 and VEGF-189, mouse monoclonal antibody to VCAM-1 (1:25 dilution; clone 1.4C3, DAKO) and mouse monoclonal antibody against Pselectin (M7199; dilution 1:25; DAKO), were used.…”

“…The main factors for this increase are not known, but may be due to changes in dietary habits, multiplicity in genetic profiles and/or to environmental exposures. We recently describe the clinicopathological characteristics of CRC in patients who underwent surgery in the GlpeTH between 1995 and 2000 [16]. Nevertheless, data on the expressions of NFκB, HIF-1α, VEGF, VCAM-1 and P-selectin in these patients are lacking.…”