Oct-4在结直肠癌组织中表达及其与预后的关系

Oct-4 expression and its relationship with clinicopathology and prognosis in colorectal cancer

目的探讨Oct-4蛋白在结直肠癌组织中的表达与患者临床病理学参数及预后的关系。方法应用免疫组化法检测本院101例结直肠癌组织中Oct-4蛋白的表达情况。分析Oct-4蛋白表达与结直肠癌临床病理参数的关系及其对患者预后的影响。结果 Oct-4蛋白在结直肠癌组织中阳性表达率为59.41%（60/101）,其阳性表达与患者性别（P=0.020）、肿瘤T分期（P=0.030）、N分期（P=0.001）、TNM分期（P〈0.001）和Duke分期（P〈0.001）显著相关。Oct-4蛋白阳性表达患者总体5年生存率为10%,显著低于阴性表达患者的总体5年生存率56.1%（P〈0.001）。Oct-4蛋白阴性表达患者5年无疾病进展生存率为51.22%,显著高于阳性表达患者5年无疾病进展生存率27.72%（P=0.001）。COX多因素回归分析结果表明肿瘤直径（HR=0.433,95%CI：0.243~0.772,P=0.005）、TNM分期（HR=3.49,95%CI：2.352~5.181,P〈0.001）和Oct-4阳性表达（HR=0.432,95%CI：0.248~0.754,P=0.005）是影响患者预后的独立危险因子。结论 Oct-4蛋白阳性表达可作为结直肠癌患者预后不佳的预测指标。

Objective To investigate the expression of Oct-4 protein and its relationships with clinicopathological parameters and prognosis in colorectal cancer. Methods Clinicopathological data of101 patients with colorectal cancer were retrospectively analyzed. The expression of Oct-4 protein was assessed by immunohistochemistry method in tumor tissues. The relationship of Oct-4 expression with clinicopathological parameters and prognosis were analyzed. Results The positive rate of Oct-4 expression in primary colorectal cancers was 59.41%（60 / 101）. The expression of Oct-4 was significantly correlated with gender（P =0.020）,T Staging（P =0.030）,N Staging（P =0.001）,TNM Staging（P〈0.001） and Duke＇s Staging（P〈0.001）. The 5-year overall survival rate（OS） of the patients with positive Oct-4 expression was10%, significantly lower than 56.1% of those with negative Oct-4 expression（P〈0.001）. The 5-year disease free survival（DFS） of the patients with negative Oct-4 expression was 51.22%, significantly higher than 27. 72 % of those with negative Oct- 4 expression（ P = 0. 008）. Multivariate COX regression analysis revealed that tumor size（HR=0.433,95% CI ：0.243 ~0.772,P =0.005） 、TNM Staging（HR =3.49,95% CI ：2.352 ~5.181,P〈0.001）and OCT-4 expression（HR =0.432,95% CI ：0.248 ~0.754,P =0.005）were independent prognostic factors for colorectal cancer patients. Conclusion The high expression of Oct-4 was observed in colorectal cancer and Oct-4 is an independent prognostic factors for colorectal cancer patients.