대한대장항문학회

Purpose: Dukes' A & B colorectal cancer patients are often excluded from adjuvant chemotherapy following potentially curative surgery because they are expected to have good long-term survival. However, actually 20∼30% of these patients suffer from recurrent disease, so it would be helpful for these patients of recurrent disease to be able to select a high risk group. Methods: In 78 Dukes' A & B colorectal cancers, we investigated by immunohistochemistry the role of molecular markers, such as p27<SUP>kip1</SUP>, p53, Ki-67, and Skp2, in identifying high-risk patients. Results: Patients with low p27<SUP>kip1</SUP> expression showed poor overall survival compared to those with high p27<SUP>kip1</SUP> expressions (55.3 versus 66.7 months, P=0.018). The only significant factor associated with p27<SUP>kip1</SUP> expression was p53 expression. The low p27<SUP>kip1</SUP> expression and positive p53 expression group had poor overall survival (54.3 months, P=0.036). Conclusions: In a node-negative colorectal carcinoma, the molecular marker p27<SUP>kip1</SUP> does not play an independent prognostic role, but it may have prognostic significance in correlation with other markers such as p53, Ki-67, and Skp2. The assessment of molecular alterations may be useful to node-negative colorectal patients in identifying the high risk group that may benefit from adjuvant chemotherapy. J Korean Soc Coloproctol 2007;23:34-40