Correlation Between MTOR And VEGF Expression And Invasion,Metastasis And Prognosis In Rectal Cancer

Objective:To detect protein expression of mTOR and VEGF in rectal normal mucosa, rectal adenomas and rectal cancer tissues, investigate the correlation between expression of mTOR and VEGF in rectal cancer tissues, analyze the correlation between their expression and invasion and metastasis, clinicopathological features and prognosis of rectal cancer, and to provide theoretical support for comprehensive treatment and prognosis of rectal cancer.Methods:Immunohistochemistry was used to detect the expression of mTOR and VEGF proteins in60,30and10tissue samples from rectal cancer, rectal adenomas and rectal normal mucosa samples, respectively, to analyze the correlation between their expression and the biological behavior of rectal cancer. And the relationship between mTOR and VEGF was assessed, as well as their prognostic significance in patients. Univariate analysis were made using Kaplan-Meier curves and assessed by the log rank test and multivariate analysis was performed using the Cox proportional hazards model to discuss the pathological features of rectal cancer prognosis, and explore the possible clinical significance.Results:The positive expression rate of mTOR in rectal cancer tissues was60%(36/60), significantly higher than that in rectal adenomas(36.7%,11/30) and normal rectal mucosa (10%,1/10),and the differences were both statistically significant(P<0.05). Expression of mTOR was significantly correlated with preoperative CEA level, tumor differentiation, TNM stage, lymph node and distant metastasis(P<0.05). Univariate analysis using the Kaplan-Meier method showed that expression of mTOR was correlated with rectal cancer prognosis. The positive expression rate of VEGF in rectal cancer tissues was70%(42/60), significantly higher than that in rectal adenomas(46.7%,14/30) and normal rectal mucosa (20%,2/10),and the differences were both statistically significant(P<0.05). Expression of VEGF was significantly correlated with TNM stage, lymph node metastasis and distant metastasis(P<0.05). Univariate analysis using the Kaplan-Meier method showed that expression of VEGF was not correlated with rectal cancer prognosis. Expression of mTOR and VEGF in cancer tissues was positively correlated(r=0.393, P<0.01). Univariate analysis showed that rectal cancer prognosis was not correlated with gender, age, tumor position, differentiation and tumor type, but correlated with preoperative CEA level, TNM staging, lymph node metastasis and distant metastasis(P<0.05). Cox multivariate survival analysis showed only distant metastasis was an independent risk factor for rectal cancer prognosis.Conclusion: 1VEGF and mTOR were both correlated with TNM stage, lymph node metastasis and distant metastasis of rectal cancer, which indicated that both of them were closely related to cancer invasion and metastasis. The assessment of two can help to predict the metastasis of rectal cancer.2Expression of mTOR was positively related to expression of VEGF, and they may promote invasion and metastasis of rectal cancer together.3VEGF and mTOR may provide a new strategy for combined treatment of rectal cancer.4The preoperative CEA level, TNM stage, lymph node metastasis and distant metastasis were related to clinical prognosis, while age, sex, tumor location, degree of differentiation and tumor morphology were not related to clinical prognosis of rectal cancer.