Correlation Of P53, VEGF And MIC-1 Expression And Prognosis In Rectal Carcinoma

Objective: To investigate the relationship between expression of p53,VEGF,MIC-1 and the characteristics of rectal cancer,the study of the respective clinical pathologic parameters and co-relationships of prognosis was analyzed. This will help to provide a theoretical basis for clinical treatment and evaluation of prognosis of rectal cancer.Methods: Seventy-three samples dated from July, 1999 to December, 2004 were taken from the Department of Pathology, at the Third Hospital of Bao Ding. The tissues were used for analysis of expression of p53 , VEGF and MIC-1. S-P immunohistochemistry techniques were utilized. All data were analyzed using the SPSS10.0 statistical software. Survival curves were prepared according to the method of Kaplan and Meier, and statistical significance between curves was tested using the log-rank test. The Cox proportional hazard model was also performed to evaluate the independent prognostic value.Survival was measured from the date of resection of RC until death or until the censor date of January 1, 2007.Results1 The immunohistochemical staining result1.1 In rectal cancer the positive expression rates of MIC-1 were 58.90%; Five-year survival rates of negative-expression group and positive-expression group were 81% , 48.02%, the differences were significant(P<0.05). With the increasing of infiltrating depth,TNM stages and the positive rate of nodal metastasis, the expression of MIC-1 protein was increasing (P<0.01). The expression of MIC-1 protein has relationship with VEGF in rectal cance(rr=0.808,P=0.000). The expression of P53 protein and P53/VEGF has relationship with MIC-1 in rectal cancer(r=0.369,P<0.01; r=-0.843,P<0.01).1.2 In rectal cancer the positive expression rates of VEGF were 54.79%; Five-year survival rates of negative-expression group and positive-expression group were 76.32% , 49.48%, the differences were significant(P<0.05).With the increasing of infiltrating depth,TNM stages and the positive rate of nodal metastasis, the expression of VEGF protein was increasing (P<0.01). The expression of P53 protein has a relationship with VEGF in rectal cancer(r=0.414,P<0.01).1.3 In rectal cancer the positive expression rates of P53 were 50.68%; Five-year survival rates of negative-expression group and positive-expression group were 75.32% , 49.84%, the differences were significant(P<0.01). With the increasing of TNM stages and the positive rate of nodal metastasis, the expression of VEGF protein was increasing (P<0.01). The expression of P53 protein has a relationship with VEGF in rectal cancer ( r=0.414 , P<0.01 ) . Five-year survival rates of P53/VEGF negative-expression group and positive-expression group were 75.32% , 49.84%, with significant differences(P<0.01).2 Clinical data result2.1 Five-year survival rates at theⅠ,Ⅱstage andⅢstage were 100%,76.81% and 46.41%,the differences were significant(P<0.01).2.2 Five-year survival rates of infiltrating serous membrane and not infiltrating were 93.33%,54.11%, the differences were significant(P<0.05).2.3 Five-year survival rates of well-differentiated,moderately differentiated and poorly differentiated were 53.18%,61.37% and53.18%, the differences were not significant(P>0.05).2.4 Five-year survival rates of male and female were 57.86%,65.56%, the differences were not significant(P>0.05).2.5 Five-year survival rates of nodal metastasis and not nodal metastasis were 83.33% , 46.41%, the differences were significant(P<0.01).2.6 Five-year survival rates of age<40y,65y>age≥40y and age≥65y were 33.33%,65.31% and 59.15%, the differences were not significant(P>0.05).2.7 Five-year survival rates of blood transfusion≤400ml and blood transfusion>400ml were 68.45%,58.33%, the difference between the two groups was not significant(P>0.05).2.8 Cox model with stepwise multivariable analysis showed nodal metastasis was important factor affecting the prognosis of rectal cancer(P<0.01). Conclusion1 The expression of MIC-1 , P53 and VEGF has a significant correlation with prognosis in rectal cancer. The cases of the positive-expression of MIC-1,P53 and VEGF showed a significantly shorter median survival time and lower five-year survival rates . Nodal metastasis was the most important available independent prognostic factor.2 The expression of P53 and VEGF has a significant correlation with MIC-1 in rectal cancer.It suggested MIC-1 play a role in the process of apoptosis and tumor angiogenesis.3 The expression of MIC-1,VEGF and P53 protein was closely related to infiltrating depth ,TNM stages and nodal metastasis.4 P53-MIC-1-VEGF was possible a signal pathway in invasion, metastasis of rectal carcinoma.