P21活化激酶1在结直肠癌中的表达及临床病理意义

Expression and clinicopathological significance of P21 activated kinase 1 in colorectal cancer

目的探讨P21活化激酶1(PAK1)在结直肠癌组织中的表达,分析其与结直肠癌患者临床病理特征及预后的关系。方法应用免疫组化SP法检测250例结直肠癌组织中PAK1的表达状态,并对患者进行随访,获得随访资料。结果PAK1阳性率为48%(120/250),在有淋巴结转移和肝转移的病例中,PAK1阳性率明显高于无淋巴结转移病例(57.6%vs42.4%)和无肝转移病例(60.0%vs44.3%),差异有统计学意义(P<0.05)。单因素生存分析显示PAK1阳性患者的生存时间较PAK1阴性者显著缩短,差异有统计学意义(P<0.05)。在单因素生存分析中,PAK1与不良预后有关。此外,结果还显示肿瘤浸润深度、淋巴结转移和肝转移与生存期相关;多因素生存分析同样显示PAK1是预后的不利因素。并且,肿瘤浸润深度、淋巴结转移、肝转移与患者的预后相关,是延长生存期的不良因素。结论在结直肠癌中,PAK1存在过度表达状态。PAK1阳性病例更易发生淋巴结转移和肝转移。PAK1的表达差异与总体生存期相关,PAK1阳性患者的生存期较PAK1阴性者显著降低,PAK1可作为独立的判断结直肠癌患者的预后指标。

Objective To investigate the expression and clinicopathological significance of P21 activated kinase 1 (PAK1) in colorectal cancer. Methods the expression of PAK1 in 250 paraffin block of colorectal cancer patients was detected by immunohistochemical SP method. Results the PAK1 positive rate was 48%(120/250). Among the cases with lymph node metastasis and liver metastasis, PAK1 positive rate was significantly higher than that of the cases without lymph node metastasis (57.6% vs 42.4%) and the cases without liver metastasis (60.0% vs 44.3%), the difference was statistically significant (P<0.05). Single factor survival analysis showed that the survival time of PAK1 positive patients was significantly shorter than that of PAK1 negative patients, and the difference was statistically significant (P<0.05). PAK1 was associated with poor prognosis in univariate survival analysis. In addition, the results showed that the depth of tumor invasion, lymph node metastasis and liver metastasis were correlated with survival. Multivariate survival analysis also showed that PAK1 was an adverse prognostic factor. Moreover, the depth of tumor invasion, lymph node metastasis and liver metastasis are related to the prognosis of patients, and are adverse factors for prolonged survival. Conclusion PAK1 is overexpressed in colorectal cancer. PAK1 positive patients were more likely to have lymph node metastasis and hepatic metastasis. The difference in PAK1 expression was related to the overall survival time, and the survival time of PAK1 positive patients was significantly lower than that of PAK1 negative patients. PAK1 could be used as an independent prognostic indicator for colorectal cancer patients.