Raf激酶抑制蛋白在Ⅱ期结直肠癌的表达及临床意义

Raf Kinase Inhibitor Protein (RKIP) Expression in Stage Ⅱ Colorectal Cancer and its Clinical Significance

目的:探讨RKIP在Ⅱ期结直肠癌中的表达及其与患者预后的关系。方法:收集130例Ⅱ期结直肠癌患者的术后组织标本,采用免疫组织化学SP法检测RKIP在原发肿瘤组织及癌旁组织中的表达,结合患者临床病理特征分析RKIP的表达水平与Ⅱ期结直肠癌患者预后的关系。结果:结直肠癌组织中RKIP的表达水平显著低于相应癌旁组织(P<0.001)。与无复发转移患者相比,复发转移患者癌组织中RKIP的表达明显降低(P=0.034)。RKIP高表达组的10年无疾病进展生存率明显优于RKIP低/中表达组(89% vs 75%,P=0.032);与RKIP低/中表达组相比,RKIP高表达组的10年总生存期有延长趋势,但无统计学意义(71%vs88%,P=0.058)。RKIP表达下降(HR 0.37;95%CI:0.13～0.99;P=0.040)和术前CEA水平升高(HR 3.50;95%CI:1.30～9.37;P=0.013)是Ⅱ期结直肠癌患者术后复发转移的危险因素。结论:RKIP在Ⅱ期结直肠癌原发肿瘤组织中表达下调,高表达患者无疾病进展生存期明显延长,提示RKIP表达水平是Ⅱ期结直肠癌患者术后复发转移的重要预后因素。

Objective： To explore the relationship of Raf kinase inhibitor protein （RKIP）expression in tumor tissue and corresponding adjacent normal tissue with the prognosis of stage Ⅱ colorectal cancer （CRC） patients. Methods： The clinical data and tumor tissue specimens of 130 stage Ⅱ CRC patients after radical operation were collected. The expression of RKIP was detected by immunohistochemistry using SP method..In addition to the clinical characteristics of the patients, the relationship between RKIP expression and the prognosis of the patients was explored. Results： RKIP expression in pd- mary tumor tissue was down-regulated compared with that in adjacent normal tissue （P〈0.001）. RKIP expression levels in primary tumor tissue from metastatic patients were lower than those from non-metastatic patients （P=-0.034）. The RKIP strong expression group had significantly longer disease free survival （DFS） than the RKIP low/medium expression group （10 yr DFS, 89% vs. 75%, P=-0.032）. Overall survival （OS） of the RKIP strong expression group was longer than the RKIP low/medium expression group with no significant difference （10 yr OS, 88% vs. 71%,P=-0.058）. Low RKIP expression （HR 0.37; 95% CI, 0.13-0.99; P=0.040）and increased preoperative serum CEA level （HR 0.37; 95% CI, 0.13-0.99; P=-0.013） were the risk factors of relapse/metastasis for stage Ⅱ CRC patients. Conclusion： RKIP expression was down-regulated in primary tumor tissue. The patients with strong RKIP expression had longer disease free survival. It is suggested that RKIP expression may be correlated with the relapse/metastasis of stage Ⅱ CRC patients after radical operation, although further research is required to confirm this.