BACKGROUND: Dukes C @entity14 is treated with adjuvant chemotherapy. Adjuvant treatment is not standard for @entity1 with @entity5 , even though about 20% of @entity1 within this @entity5 stage die of recurrent disease. The authors investigated whether a novel method of simultaneous detection of apoptosis and proliferation would improve the assessment of prognosis in @entity14 @entity1 , with the ultimate goal of accurately identifying @entity1 eligible for adjuvant therapy. METHODS: A multiparameter flow cytometric assay with heat pretreatment was performed on 278 paraffin-embedded @entity14 . After immunochemical isolation of @entity5 cells, apoptosis and proliferation were assessed simultaneously by immunostaining for the M30 antibody and by quantitative DNA analysis, respectively. @entity1 were followed for more than 10 years. RESULTS: The mean values of apoptosis (apoptotic fraction [AF], i.e., the percentage of M30-positive cells) and proliferation (S-phase fraction [SPF]) were 11.1% and 13.1%, respectively. The AF and SPF values were correlated positively (P = 0.01) and both increased with advancing @entity5 stage (P = 0.02). Combining AF and SPF, @entity1 with @entity5 with a high turnover (i.e., both AF and SPF values were greater than the mean) had an overall survival rate of 13%, whereas @entity1 with @entity5 (i.e., both AF and SPF values were less than the mean) had an overall survival rate of 89% (P < 0.001 by log rank test). Moreover, within Dukes B and C stages, @entity1 with @entity5 had a poorer survival than @entity1 with @entity5 (P < 0.001 for both stages). CONCLUSIONS: The simultaneous detection of apoptosis and proliferation in archival material allows separation of high and low-turnover @entity14 and improves the assessment of prognosis. This technique could be used to stratify @entity1 for adjuvant chemotherapy.

Simultaneous detection of apoptosis and proliferation in @entity14 by multiparameter flow cytometry allows separation of high and XXXX with distinct clinical outcome.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'high-turnover tumors', 'tumors', 'Dukes B tumors', 'low-turnover tumors'] @entity14 :: ('MESH:D015179', 'Disease') :: ['colorectal carcinoma', 'colorectal adenocarcinomas']
@entity5 :: (MESH:D009369,Disease) :: ['low-turnover tumors']
