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World J Gastroenterol. Mar 14, 2006; 12(10): 1626-1629
Published online Mar 14, 2006. doi: 10.3748/wjg.v12.i10.1626
Using p53-immunostained large specimens to determine the distal intramural spread margin of rectal cancer
Zhi-Zhong Pan, De-Sen Wan, Chang-Qing Zhang, Jian-Yong Shao, Li-Ren Li, Gong Chen, Zhi-Wei Zhou, Fu-Long Wang
Zhi-Zhong Pan, De-Sen Wan, Chang-Qing Zhang, Jian-Yong Shao, Li-Ren Li, Gong Chen, Zhi-Wei Zhou, Fu-Long Wang, Department of Abdominal Surgery, Cancer Hospital, Sun Yat-Sen University, Guangzhou 510060, Guangdong Province, China
Author contributions: All authors cotributions equally to the work.
Correspondence to: Zhi-Zhong Pan, Department of Abdominal Surgery, Cancer Center, Sun Yat-Sen University, 651 Dongfeng Road, Guangzhou 510060, Guangdong Province, China. panzhizhong@medmail.com.cn
Telephone: +86-20-87343461 Fax: +86-20-87343392
Received: November 2, 2004
Revised: November 23, 2004
Accepted: December 9, 2004
Published online: March 14, 2006
Abstract

AIM: To determine the distal intramural spread (DIS) margin of rectal cancer.

METHODS: Sixty-one p53-positive specimens of rectal cancer were used. After conventional hematoxylin and eosin (H&E) staining, the DIS margin of rectal cancer in large specimens was examined by immunohistochemistry. The patients were divided into A, B, C, and D groups. After a long-term follow-up, the survival curves of the four groups were estimated using the life table.

RESULTS: Fifty-one of the sixty-one cases (83.6%) had DIS. The extent of DIS ranged 0.11-3.5 cm; meanwhile the mean of DIS measured by H&E staining was 0.13 cm. The significant difference was found between the means (t=5.622, P<0.0001). Only 1 of 51 patients had DIS greater than 3 cm. The DIS was less than 1.0 cm in most rectal cancer patients. The long-term results indicated that the survival rate of the patients whose DIS was greater than 1.0 cm was lower than that of the patients whose DIS was less than 0.5 cm.

CONCLUSION: Rectal cancer patients with DIS greater than 1.0 cm have poor prognosis.

Keywords: Rectal cancer; Distal intramural spread; p53; Immunohistochemistry; Large specimen