DCAMKL-1和p53对结直肠癌患者预后的影响

Effect of DCAMKL-1 and p53 on prognosis of colorectal cancer patients

目的评估DCAMKL-1和p53蛋白在结直肠癌中的表达,分析两者与结直肠癌患者临床病理特征的关系及对预后的影响。方法应用免疫组织化学法检测126例结直肠癌及癌旁正常黏膜组织中DCAMKL-1和p53蛋白的表达,分析其在结直肠癌中表达的意义及与患者临床病理特征、预后的关系。结果结直肠癌DCAMKL-1阳性率为71.4%(90/126)明显高于癌旁正常黏膜(P<0.05);DCAMKL-1的表达与年龄、性别、肿瘤分化程度、临床分期、淋巴结转移无关(P>0.05)。结直肠癌和癌旁正常肠黏膜p53阴性、弱阳性、弥漫强阳性表达率分别为25.4%(32/126)、14.3%(18/126)、60.3%(76/126)和92.1%(116/126)、7.9%(10/126)、0(0/126),结直肠癌p53弥漫强阳性表达率60.3%(76/126)明显高于癌旁正常黏膜(P<0.05)。p53与临床分期及淋巴结转移有关(χ^2=3.925、7.292,P<0.05),p53阴性和弥漫强阳性表达时肿瘤更易发生淋巴结转移(P<0.05)。多因素生存分析显示临床分期是影响结直肠癌患者预后的独立危险因素(P<0.05)。结论DCAMKL-1、p53与结直肠癌的发生密切相关,p53与结直肠癌的临床分期和淋巴结转移有关,且临床分期是影响患者预后的独立危险因素。

Objective To investigate the correlation of DCAMKL-1 and p53 expression with pathological characteristics of colorectal carcinoma(CRC)and patients′prognosis.Methods DCAMKL-1 and p53 expression in 126 cases CRCs and ANM.The correlations of their expression with patients′pathological characteristics and prognosis were evaluated based on Spearman correlation analysis and survival analysis.Results In CRCs,the positive rate of DCAMKL-1 was 71.4%(90/126),which was significantly higher than that of ANMs(P<0.05).There was no correlation between DCAMKL-1 expression and patients′age,gender,clinical stage,lymph node metastases(P>0.05).The distributions of CRCs and ANMs were 25.4%(32/126),14.3%(18/126),60.3%(76/126)and 92.1%(116/126),7.9%(10/126),0(0/126)in the p53-no,mild and strong expression groups,respectively.In CRCs,the strong positive rate of p53 was 60.3%(76/126),which was significantly higher than that of ANMs(P<0.05).The expression of p53 was associated with clinical stage(χ^2=3.925,P<0.05)and lymph node metastasis(χ^2=7.292,P<0.05).The CRCs with p53-no and p53 strong expression are prone to metastasize(P<0.05).Multivariate analysis revealed that clinical stage was independent prognostic factors of CRC patients(P<0.05).Conclusions DCAMKL-1 and p53 are closely related to the occurrence of CRC.p53 is related to the clinical stage and lymph node metastasis.Clinical stageis independent prognostic indicator of CRC.