Doublecortin样激酶-1在胃癌组织中的表达及其与预后关系

Expression of Doublecortin-like Kinase 1 in Human Gastric Cancer and Its Correlation with Prognosis

目的研究doublecortin样激酶-1(DCLK1)在胃癌组织的表达情况及其与患者临床病理特征及预后的关系。方法收集北京协和医院2002年7月至2006年12月收治的122例胃癌根治患者的临床病理资料及标本,采用免疫组织化学法检测DCLK1在胃癌及癌旁组织中的表达水平,Kaplan-Meier法绘制生存曲线,Cox比例风险模型进行单因素及多因素生存分析。结果 122例胃癌患者中,51例存在DCLK1高表达。DCLK1与患者淋巴结转移(P=0.029)、脉管癌栓(P=0.029)密切相关。Kaplan-Meier分析结果显示,DCLK1高表达者的5年总生存率和5年无病生存率分别为39.0%和37.0%,明显低于DCLK1低表达者的65.8%和64.5%(P均=0.001)。Cox模型分析结果显示,DCLK1是胃癌患者总生存时间和无病生存时间的独立预后因素(P均=0.036)。结论 DCKL1高表达与胃癌淋巴结转移和脉管癌栓相关,是胃癌患者预后不良的一个潜在分子指标。

Objective To investigate the expression of doublecortin-like kinase 1 （DCLK1） in gastric cancer and its prognostic significance. Methods The expression of DCLK1 was examined by immunohistochemi- cal staining of paraffin-embedded tumor specimens from 122 patients who underwent curative gastrectomy for gas- tric cancer at Peking Union Medical College Hospital between July 2002 and December 2006. Survival curves were described by the Kaplan-Meier method and compared by the Log-rank test. Univariate and multivariate analysis was performed with the Cox proportional hazard model. Results The expression of DCLK1 in tumor cells was sig- nificantly upregnlated in 51 of 122 patients. High expression of DCLK1 in tumor cells was strongly correlated with pN stage （P = 0. 029 ） and lymphovascular invasion （P = 0. 029 ） . Kaplan-Meier analysis revealed that patients with DCLK1 high expression had a significantly lower 5-year overall survival （OS） rate than that of patients with DCLK1 low expression （ 39.0% vs. 65.8% , P = 0. 001 ） , as well as a significantly lower 5-year disease-free survival （DFS） rate （37.0% vs. 64.5%, P = 0.001 ） . Univariate and multivariate analyses showed that DCLK1 expression （both P = 0. 036） was an independent factor for predicting OS and DFS rate. Conclusions High expression of DCLK1 in gastric cancer cells is associated with pN stage and lymphovascular invasion. It may be a predictor for poor survival in patients undergoing surgery for gastric cancer.