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Scott E. Kern, MD; Eric R. Fearon, BA; Kasper W. F. Tersmette, MD; John P. Enterline, MS; Mark Leppert, PhD; Yusuke Nakamura, MD, PhD; Ray White, PhD; Bert Vogelstein, MD; Stanley R. Hamilton, MD

JAMA. 1989;261(21):3099-3103.

Abstract
Clinical and pathological associations with molecular genetic alterations were studied in colorectal carcinomas from 83 patients. Fractional allelic loss, a measure of allelic deletions throughout the genome, and allelic deletions of specific chromosomal arms (the short arm of 17 and long arm of 18) each provided independent prognostic information by multivariate analysis when considered individually with Dukes'classification. Distant metastasis was significantly associated with high fractional allelic loss and with deletions of 17p and 18q. Mutations of ras proto-oncogenes and deletions of 5q had no prognostic importance. Statistically significant associations were also found between allelic losses and a family history of cancer, left-sided tumor location, and absence of extracellular tumor mucin. Allelic deletion analysis thus identified subsets of colorectal carcinoma with increased predilection for distant metastasis and cancer-related death. Further studies may define a subset of genetic alterations that can be used clinically to help assess prognosis.

(JAMA. 1989;261:3099-3103)

Author Affiliations
From the Department of Pathology (Drs Kern, Tersmette, and Hamilton) and the Oncology Center (Drs Kern, Vogelstein, and Hamilton and Messrs Fearon and Enterline), The Johns Hopkins Medical Institutions, Baltimore, Md; and the Department of Human Genetics, The University of Utah School of Medicine, Salt Lake City (Drs Leppert, Nakamura, and White).

Footnotes
Reprint requests to the Department of Pathology, The Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21205 (Dr Kern).

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