A Study Of The Association Between CD44v6,p16,Ki67,MMP-9 And Colorectal Carcinoma Prognosis

Objective:Discussing the relation between CD44v6,p16,Ki67,MMP-9 andcolorectal cancer prognosis,that provides definite science bases for clinicphysician evaluating and prognosing colorectal cancer patients.Methods:Collecting 1989.1～1991.12 120 original CRC cases through radicaltreatment resection in shanxi province Cancer hospital with passinghistopathology final diagnosis and without passing any systemic radiothera-peutics and chemiotherapy in preoperative,as well as all markers for analysisrecorded integrity and all cases have follow-up datas for five years.We adoptconsulting disease-cases methods to investigate.In order to guarantee reliabilityof the datas,the investigaters are all teached unifily and fill in the questionariesbasing the questionaries of prior studing out before collecting datums;At onetime,we get the paraffine blocks keeping in the archives of above-bases,doing5um serial sects(part dipping paraffin and embedded newly),conserving in 4℃or room temperature to use immunohistochemistry staining.We would input allinquiring datas including laboratory results in computer and set up data-base,then using SPSS11.5,CART5.0 and SAS8.0 to treat with and analyze.Results:1.Immunohistochemistry examining results of CD44v6,p16,Ki67 and MMP-9 proteins in CRC:the positive expression rate of CD44v6,p16,Ki67 and MMP-9 proteins in 120 CRC patients is 31.70%(38/120),40.80%(49/120),55.80%(67/120)and 46.70%(56/120),respectively.2.The relation between the positive expression rates of CD44v6,p16,Ki67and MMP-9 proteins and clinic pathology characters and CRC prognosis:There are relation between CD44v6 protein and lymph node metastasis,Dukes′stage,five-years survival times; There are relation between p16 proteinand general tying,five-years survival times;There are relation between Ki67protein and tumour place,lymph node metastasis,Dukes′stage,five-yearssurvival times;There are relation between MMP-9 protein and lymph nodemetastasis,five-years survival times.3. The relation of between the positive expression rates of CD44v6,p16,Ki67,MMP-9 proteins,Dukes′stage and sufferer survival periods:Thereare all significance difference between the positive expression rates of CD44v6,p16,Ki67,MMP-9 proteins,Dukes′stage and sufferer survival periods throughLog-rank tests,P value is less than 0.05.4. Cox single-factor and more-fators analyse : By Cox single-factoranalyzing,general type,histology type,invasion depth,lymph node metastasis,Dukes stage and CD44v6,p16,Ki67,MMP-9 are significal prognosis fators inа=0.05 level;By Cox more-fators analyzing,Dukes stage,p16 and MMP-9enter into final model , their RR values 3.138 , 0.444 and 1.841 ,respectively;prognostic model is h(t,x)=h0(t)exp(1.144X₉+0.610X₁₃-0.813X₁₁),under а=0.05 level,the model is statistic significance(χ²=44.436,P<0.001 )by χ² tests;according to individual prognostic indexformula:PI(PV)=β₀+1.144X₉+0.610X₁₃-0.813X₁₁,we know that prognosticresults and real results are bettet in anastomose degree(χ²=0.129,P>0.05),sensitive 79.10%,speciative 67.92% and Kappa value 0.4731.5.Classification tree analysis:using arithmetic of CART(Classification AndRegression Tree) and CHAID(Chi-square Automatic Interaction Detection),we educe that Dukes′stage is a most significance difference influencing CRCpatients prognosis;Secondly,there are CD44v6 protein and lymph nodemetastasis.6.Interaction analyzing:There are positive interaction between lympth nodemetastasis and CD44v6 protein(RERI=13.080,95%CI is 7.241～19.061;API=0.747,95%CI is 0.418～1.076;S=4.825, 95%CI is 1.048～22.221)viz bothis possibly cooperating action,the positive expression rate of CD44v6 is higherwhen there is lympth node metastasis;the action between lympth nodemetastasis and MMP-9 is resemble to CD44v6(RERI=6.470,95%CI is 4.284～10.224;API=0.548,95%CI is 0.061～1.035;S=2.491,95%CI is 1.070～8.864).Conclusions:Dukes′stage,p16 and MMP-9 are possibly independ factorsinfluencing CRC prognosis,thereout setting CRC prognostic model has uppereffect degree and reli...