The DCC protein and prognosis in colorectal cancer

N Engl J Med. 1996 Dec 5;335(23):1727-32. doi: 10.1056/NEJM199612053352303.


Background: Allelic loss of chromosome 18q predicts a poor outcome in patients with stage II colorectal cancer. Although the specific gene inactivated by this allelic loss has not been elucidated, the DCC (deleted in colorectal cancer) gene is a candidate. We investigated whether the expression of the DCC protein in tumor cells is a prognostic marker in colorectal carcinoma.

Methods: The expression of DCC was evaluated immunohistochemically in 132 paraffin-embedded samples from patients with curatively resected stage II and III colorectal carcinomas. The Cox proportional-hazards model was used to adjust for covariates including age, sex, tumor site, degree of tumor differentiation, and use of adjuvant therapy.

Results: The expression of DCC was a strong positive predictive factor for survival in both stage II and stage III colorectal carcinomas. In patients with stage II disease whose tumors expressed DCC, the five-year survival rate was 94.3 percent, whereas in patients with DCC-negative tumors, the survival rate was 61.6 percent (P<0.001). In patients with stage III disease, the respective survival rates were 59.3 percent and 33.2 percent (P=0.03).

Conclusions: DCC is a prognostic marker in patients with stage II or stage III colorectal cancer. In stage II colorectal carcinomas, the absence of DCC identifies a subgroup of patients with lesions that behave like stage III cancers. These findings may thus have therapeutic implications in this group of patients.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Biomarkers, Tumor / analysis*
  • Biomarkers, Tumor / genetics
  • Cell Adhesion Molecules / analysis*
  • Cell Adhesion Molecules / genetics
  • Colorectal Neoplasms / chemistry*
  • Colorectal Neoplasms / genetics
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / pathology
  • DCC Receptor
  • Female
  • Gene Expression
  • Genes, DCC / genetics*
  • Humans
  • Immunohistochemistry
  • Life Tables
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Proportional Hazards Models
  • Receptors, Cell Surface
  • Survival Rate
  • Tumor Suppressor Proteins*


  • Biomarkers, Tumor
  • Cell Adhesion Molecules
  • DCC Receptor
  • DCC protein, human
  • Receptors, Cell Surface
  • Tumor Suppressor Proteins