Abstract
The 5T4 oncofetal antigen is a 72 kDa glycoprotein defined by a monoclonal antibody raised against human placental trophoblast and is expressed in many different carcinomas but detected only at low levels in some normal epithelia. Immunohistochemical analysis of the patterns of expression in colorectal carcinomas has indicated a significant association between the presence of the antigen in tumour cells and metastatic spread. The 5T4 antigen phenotype of 72 colorectal cancers has been compared with the clinical outcome of the patients in order to assess its relationship with prognosis. Forty per cent of tumours were 5T4 positive; the remainder were either unlabelled or exhibited stroma-associated labelling only. There was a significant correlation between 5T4 expression in the malignant cells and unfavourable course of disease (P < 0.001). The 5 year survival with 5T4-positive tumours was 22% compared with 75% for patients with 5T4-negative tumours; median survival was 24 versus > 90 months respectively. Stratified analysis showed that 5T4 antigen tumour positivity was acting independently of each of stage, site of tumour, age or sex. There were significant differences in survival for patients with Dukes' B and C stage carcinomas (P = 0.001 and P = 0.034). The results suggest that in colorectal cancer immunohistochemical assessment of 5T4 expression may be useful in identifying patients at high risk for tumour recurrence and for whom additional treatment strategies might be most appropriate.
Full text
PDF



Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Eisenberg B., Decosse J. J., Harford F., Michalek J. Carcinoma of the colon and rectum: the natural history reviewed in 1704 patients. Cancer. 1982 Mar 15;49(6):1131–1134. doi: 10.1002/1097-0142(19820315)49:6<1131::aid-cncr2820490611>3.0.co;2-t. [DOI] [PubMed] [Google Scholar]
- Fearon E. R., Vogelstein B. A genetic model for colorectal tumorigenesis. Cell. 1990 Jun 1;61(5):759–767. doi: 10.1016/0092-8674(90)90186-i. [DOI] [PubMed] [Google Scholar]
- Hole N., Stern P. L. A 72 kD trophoblast glycoprotein defined by a monoclonal antibody. Br J Cancer. 1988 Mar;57(3):239–246. doi: 10.1038/bjc.1988.53. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hole N., Stern P. L. Isolation and characterization of 5T4, a tumour-associated antigen. Int J Cancer. 1990 Jan 15;45(1):179–184. doi: 10.1002/ijc.2910450132. [DOI] [PubMed] [Google Scholar]
- Kern S. E., Fearon E. R., Tersmette K. W., Enterline J. P., Leppert M., Nakamura Y., White R., Vogelstein B., Hamilton S. R. Clinical and pathological associations with allelic loss in colorectal carcinoma [corrected]. JAMA. 1989 Jun 2;261(21):3099–3103. doi: 10.1001/jama.261.21.3099. [DOI] [PubMed] [Google Scholar]
- Krook J. E., Moertel C. G., Gunderson L. L., Wieand H. S., Collins R. T., Beart R. W., Kubista T. P., Poon M. A., Meyers W. C., Mailliard J. A. Effective surgical adjuvant therapy for high-risk rectal carcinoma. N Engl J Med. 1991 Mar 14;324(11):709–715. doi: 10.1056/NEJM199103143241101. [DOI] [PubMed] [Google Scholar]
- Laurie J. A., Moertel C. G., Fleming T. R., Wieand H. S., Leigh J. E., Rubin J., McCormack G. W., Gerstner J. B., Krook J. E., Malliard J. Surgical adjuvant therapy of large-bowel carcinoma: an evaluation of levamisole and the combination of levamisole and fluorouracil. The North Central Cancer Treatment Group and the Mayo Clinic. J Clin Oncol. 1989 Oct;7(10):1447–1456. doi: 10.1200/JCO.1989.7.10.1447. [DOI] [PubMed] [Google Scholar]
- Matturri L., Biondo B., Uggeri F., Lavezzi A. M. Densitometric evaluation of DNA content in colorectal cancer. Eur J Cancer. 1991;27(7):893–896. doi: 10.1016/0277-5379(91)90141-y. [DOI] [PubMed] [Google Scholar]
- Moertel C. G., Fleming T. R., Macdonald J. S., Haller D. G., Laurie J. A., Goodman P. J., Ungerleider J. S., Emerson W. A., Tormey D. C., Glick J. H. Levamisole and fluorouracil for adjuvant therapy of resected colon carcinoma. N Engl J Med. 1990 Feb 8;322(6):352–358. doi: 10.1056/NEJM199002083220602. [DOI] [PubMed] [Google Scholar]
- O'Connell M. J., Schaid D. J., Ganju V., Cunningham J., Kovach J. S., Thibodeau S. N. Current status of adjuvant chemotherapy for colorectal cancer. Can molecular markers play a role in predicting prognosis? Cancer. 1992 Sep 15;70(6 Suppl):1732–1739. doi: 10.1002/1097-0142(19920915)70:4+<1732::aid-cncr2820701614>3.0.co;2-#. [DOI] [PubMed] [Google Scholar]
- Peto R., Pike M. C., Armitage P., Breslow N. E., Cox D. R., Howard S. V., Mantel N., McPherson K., Peto J., Smith P. G. Design and analysis of randomized clinical trials requiring prolonged observation of each patient. I. Introduction and design. Br J Cancer. 1976 Dec;34(6):585–612. doi: 10.1038/bjc.1976.220. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Peto R., Pike M. C., Armitage P., Breslow N. E., Cox D. R., Howard S. V., Mantel N., McPherson K., Peto J., Smith P. G. Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. analysis and examples. Br J Cancer. 1977 Jan;35(1):1–39. doi: 10.1038/bjc.1977.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ponz de Leon M., Sant M., Micheli A., Sacchetti C., Di Gregorio C., Fante R., Zanghieri G., Melotti G., Gatta G. Clinical and pathologic prognostic indicators in colorectal cancer. A population-based study. Cancer. 1992 Feb 1;69(3):626–635. doi: 10.1002/1097-0142(19920201)69:3<626::aid-cncr2820690305>3.0.co;2-#. [DOI] [PubMed] [Google Scholar]
- Silverberg E., Boring C. C., Squires T. S. Cancer statistics, 1990. CA Cancer J Clin. 1990 Jan-Feb;40(1):9–26. [PubMed] [Google Scholar]
- Southall P. J., Boxer G. M., Bagshawe K. D., Hole N., Bromley M., Stern P. L. Immunohistological distribution of 5T4 antigen in normal and malignant tissues. Br J Cancer. 1990 Jan;61(1):89–95. doi: 10.1038/bjc.1990.20. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Starzynska T., Rahi V., Stern P. L. The expression of 5T4 antigen in colorectal and gastric carcinoma. Br J Cancer. 1992 Nov;66(5):867–869. doi: 10.1038/bjc.1992.375. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tomoda H., Kakeji Y., Furusawa M. Prognostic significance of flow cytometric analysis of DNA content in colorectal cancer: a prospective study. J Surg Oncol. 1993 Jul;53(3):144–148. doi: 10.1002/jso.2930530303. [DOI] [PubMed] [Google Scholar]
- Turnbull R. B., Jr, Kyle K., Watson F. R., Spratt J. Cancer of the colon: the influence of the no-touch isolation technic on survival rates. Ann Surg. 1967 Sep;166(3):420–427. doi: 10.1097/00000658-196709000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Vogelstein B., Fearon E. R., Kern S. E., Hamilton S. R., Preisinger A. C., Nakamura Y., White R. Allelotype of colorectal carcinomas. Science. 1989 Apr 14;244(4901):207–211. doi: 10.1126/science.2565047. [DOI] [PubMed] [Google Scholar]
- Witzig T. E., Loprinzi C. L., Gonchoroff N. J., Reiman H. M., Cha S. S., Wieand H. S., Katzmann J. A., Paulsen J. K., Moertel C. G. DNA ploidy and cell kinetic measurements as predictors of recurrence and survival in stages B2 and C colorectal adenocarcinoma. Cancer. 1991 Aug 15;68(4):879–888. doi: 10.1002/1097-0142(19910815)68:4<879::aid-cncr2820680434>3.0.co;2-4. [DOI] [PubMed] [Google Scholar]

