| ObjectivesTo study the relationship between the expression and clinical pathological significance of proliferating cell nuclear antigen Ki67 and transcription factor Klf4 in colorectal adenocarcinoma. To observe the distribution, morphology, pathological relationship of CD44+/C-myc+phenotype cells in colorectal cancer and then to research the value and significance of CD44+/C-myc+ phenotype cells. To analysis the relationship between the expression of Ki67, Klf4, CD44+/C-myc+ phenotype cells and the prognosis of colorectal adenocarcinoma patients.MethodTo collected the message of colorectal adenocarcinoma patients from 2007.03 to 2012.09 in Lanzhou General Hospital of Lanzhou Military Command (150 cases operation patients were complete resected the tumor), and to obtained patients cancer tissue paraffin embedded specimens. And 34 cases adenoma (someone associated with atypical hyperplasia),10 cases normal tissue and adjacent tissue which away from cancer tissue as a control. By using tissue microarray, immunohistochemical staining, immunofluorescence double staining and immunohistochemical double staining to observe the expression of Ki67 protein and Klf4 protein in colorectal adenocarcinoma, to explore the relationship between the expression and the clinical pathological parameters of those. To observed distribution, expression, shapes and sizes of CD44+/C-myc+ phenotype cells in the cancer tissue, and to explored whether CD44+/C-myc+ phenotype cells would be as a colorectal adenocarcinoma stem cell maker. By telephone, outpatient visits or other means, to collected the survival information, and then to analysis the relationship between the expression and the patients prognosis of Ki67 protein, Klf4 protein, CD44+/C-myc+phenotype cells. P≤0.05 mean the difference was statistically significant.by using IBM SPSS 19.0Results1、The expression of Ki67 and Klf4 were significant differences in different tissues(P<0.05); the positive expression of Ki67 and KLF4 in the same tissue were opposite; the expression of Ki67 is associated with invasion, pathological grading (P< 0.05); and the expression of KLF4 was negatively related to the pathological grade (P< 0.05).2、CD44+/C-myc+phenotype cells were not expressed in normal mucosa (0/10), rarely expressed in adenomas (5/34), and the number of CD44+/C-myc+phenotype cells was significantly increased in adenocarcinoma (122/150), the difference had statistically significant in different tissues (P< 0.05); the number of CD44+/C-myc+phenotype cells were related to degree, invasion depth, lymph node metastasis(P< 0.05); we observed that all CD44+/C-myc+phenotype cells were in same morphology:large nucleus oval, homogeneous hyperchromatic, less cytoplasm, cells were similar to lymphocyte, expressed at base of buct in carcinoma adenoid tissue and the common wall of adenoid tissue.3、Each clinical pathologic factors were imported to Cox model, the single factor analysis found that the overall survival rate and progression free survival rate of patients with colorectal cancer were related to the number of CD44+/C-myc+phenotype cells, lymph node metastasis, Ducksstage (P< 0.05).4、To put the pathological parameter into the Cox proportional hazard model and use "Forward:wald" calculation method to multi factor analysis, we found that the total survival rate of patients were only related to the number of CD44+/C-myc+phenotype cell, none related to other pathological parameters (P<0.05); the progression free survival rate were related to Klf4 expression, the number of CD44+/C-myc+phenotype cells and Duks stage (P< 0.05).Conclusion1、KLF4 may play a role of suppressor gene in tumor.2、CD44+/C-myc+phenotype cells may be tumor stem cell in colorectal adenocarcinoma.3、The number of CD44+/C-myc+phenotype cells, Klf4 expression, lymph node metastasis and Ducks staging are important factors to influence the patients prognosis. |
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