| Objective:To investigate the expression of BAK, BAG-1 and CDK4 in colorectal carcinoma, and to provide a new pathological evidence for evaluating clinical treatment and prognosis and its relationship.Methods:Expression of BAK, BAG-1 and CDK4 was detected by immunohistochemistry method in 25 normal colorectal tissues,40 colorectal adenomas and 80 colorectal cancers. Their relationship with sex, age, the location of the tumor, tumor sizes, histology type, cell differentiation, the depth of invasion, lymphametastasis and distant metastasis was analyzed.Results:The positive expression rate of BAK, BAG-1 and CDK4 in 25 cases of normal colorectal tissue were 20%(5/25),12%(3/25),8%(2/25) respectively; in 40 cases of colorectal adenomas were 50%(20/40),62.5%(25/40),30%(12/40) respectively; in 80 cases of colorectal carcinoma were 72.5%(58/80),80%(64/80),65%(52/80) respectively; The positive expression rate of BAK, BAG-1 and CDK4 was significantly higher in colorectal carcinoma than that in normal colorectal mucosa and adenomas tissues (P＜0.05). The positive expression rate of BAK,BAG-1 and CDK4 were found 66.7%(26/39),79.5%(31/39) and 69.2%(27/39) in male group; 78%(32/41),80.5%(33/41) and 61%(25/41) in female group, there were not significant difference(P>0.05).The positive expression rate of BAK and BAG-1 were found 69.2%(18/26),84.6%(22/26) in less than 54-year-old group; 74.1% (40/54),77.8%(42/54) in greater than or equal to 54 age group,there were not significant difference(P>0.05). But The positive expression rate of CDK4 were found 42.3%(11/26)in less than 54-year-old group; 75.9%(41/54) in greater than or equal to 54 age group.there were significant difference respectively(P＜0.05).The positive expression rate of BAK, BAG-1 and CDK4 were 73.7%(28/38),76.3%(29/38),73.7%(28/38) in rectum group; 71.4%(30/42), 83.3%(35/42),57.1%(24/42) in colon group. There were not significant difference(P＞0.05).The positive expression rate of BAK and BAG-1 were found 63.9%(23/36), 83.3%(30/36) in tumor diameter of greater than 3 cm; 79.5%(35/44),77.3%(34/44) in tumor diameter of less than 3 cm, there were not significant difference(P＞0.05). But the positive expression of CDK4 were found 83.3%(30/36) in tumor diameter of greater than 3 cm; 50%(22/44) in tumor diameter of less than 3 cm, there were significant difference respectively(P＜0.01).The positive expression rate of BAK, BAG-land CDK4 were also found 68.6%(24/35),85.7%(30/35),60%(21/35) in tubular adenocarcinoma; 75.6%(34/45), 75.6%(34/45),68.9%(31/45) in papillary adenocarcinoma, there were not significant in difference different histological types of colorectal adenocarcinoma (P＞0.05). The positive expression rate of BAK were found 92.3%(24/26) in higher differentiated group; 75%(27/36) in intermediate differentiated group; 38.9%(7/18) in poorly differentiated group. With the reduction in cell differentiation, the positive expression rate of BAK were lower, there were significant difference(P＜0.05). But the positive expression rate of BAG-1 and CDK4 were found 61.5%(16/26),50%(13/26) in higher differentiated group; 86.1%(31/36),63.9% (23/36) in in intermediate differentiated group; 94.4%(17/18),88.9%(16/18) in poorly differentiated group. With the reduction in cell differentiation, the positive expression rate of BAG-1 and CDK4 were higher, there were significant difference(P＜0.05). The positive expression rate of BAK and BAG-1 were found 67.6%(23/34),82.3%(28/34) in T0-T2 group; 76.1%(35/46),78.3%(36/46) in T3-T4 group, there were not significant difference(P＞0.05). But the positive expression rate of CDK4 were found 50%(17/34) in T0-T2 group; 76.1% (35/46) in T3-T4 group, there were significant difference respectively(P＜0.05).The positive expression rate of BAK were found 74%(37/50) in No group; 70%(21/30) in N1-N3 group, there were not significant difference(P＞0.05). But the positive expression rate of BAG-1 and CDK4 were found 70%(35/50),54%(27/50) in N0 group; 96.67%(29/30),83.33%(25/30) in N1-N3 group, there were significant difference respectively(P＜0.05).The positive expression rate of BAK were found 69.8%(30/43) in Mo group; 75.7%(28/37) in M1 group, there were not significant difference(P＞0.05). But the positive expression rate of BAG-1 and CDK4 were found 69.8%(30/43),51.1%(22/43) in M0 group; 92%(34/37),81.1%(30/37) in M1 group, there were significant difference respectively(P＜0.05).The expression of BAK was negatively correlated with BAG-1(x2=7.586,P＜0.05,r=-0.308), the expression of BAK was negatively correlated with CDK4 (x2=8.954,P＜0.05,r=-0.335), the expression of BAG-1 was positively correlated with CDK4(x2=14.066,P＜0.05,r=0.419)。Conclusion:1 The positive expression of BAK was positively correlated with the degree of differentiation of colorectal cancer,but the expression of BAK is independent of patient age and gender,site, tumor diameter, histological type, depth of invasion, lymph node metastasis, distant metastasis.2 The positive expression of BAG-1 was closely related with the degree of differentiation of colorectal cancer, lymph node metastasis, distant metastasis. But the expression of BAG-1 is independent of patient age and gender, site, tumor diameter,histological type, depth of invasion.3 With the higher grade, the positive expression of CDK4 were higher in every grade. The results show that the expression of CDK4 is to some extent Related with the disease progression.The expression of CDK4 is closely related with patient age,tumor diameter, depth of invasion, lymph node metastasis and distant metastasis, independent of gender, lesion site, and histological type.4 The expression of BAK was negatively correlated with BAG-1, The expression of BAK was also negatively correlated with CDK4. In the evolution of colorectal adenocarcinoma,BAK,BAG-1 and CDK4, in addition to their direct role,they can also inhibit the expression of other proteins and indirectly play a role. The expression of BAG-1 was positively correlated with CDK4,the results show that both in colorectal cancer genesis and development play the role of mutually reinforcing.
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