Expression Of SIX1 In Rectal Cancer And Its Relationship With Histopathology

Objective To investigate the expression of homeobox protein gene 1(Six1)in rectal cancer and its correlation with tumor histopathology and prognosis,and analyze its influence on the development of rectal tumors.Clinical diagnosis and treatment and prognosis evaluation provide a relatively new auxiliary reference basis.Methods Including 113 cases of rectal cancer patients who underwent radical rectal cancer surgery in our hospital from February 2011 to March 2014,collected the relevant patients’ pathological specimens in the pathology department of our hospital and applied the immunohistochemical method to the relevant specimens.After screening qualified specimens,the expression of Six1 protein in the tissues of the sliced specimens was evaluated.The specific expression level was determined by the relative integrated optical density value(IDO)of the target protein to quantify the immunohistochemical results of the specimen.Analyze and compare the differences and characteristics of Six1 protein expression in rectal cancer tissues and adjacent tissues.Combined with the application of clinical specific information,we explored the relationship between Six1 expression and tumor histology through univariate analysis and multivariate analysis,and analyzed its impact on the 5-year survival rate of rectal cancer by Kaplan-Meier(KM)survival curve.Furthermore,the relationship between Six1 protein and long-term survival of patients with rectal cancer was evaluated.Results 1.Immunohistochemical analysis showed that the relative IDO value of Six1 in rectal cancer tissue was(3.64 ± 0.57)and the relative IDO value of neighboring tissues was(1.00 ± 0.36).The expression of Six1 protein in cancer tissue was significantly higher than that in adjacent tissues.The t test showed that P <0.01 was statistically significant.2.Correlation analysis by Spearman test can show that the expression of Six1 in rectal cancer tissues is closely related to clinical tumor markers such as CEA and CA19-9,and the expression of Six1 and CEA in peripheral blood has a significant positive correlation(r = 0.056,P <0.01);At the same time,it had a significant positive correlation with the expression of CA19-9 in peripheral blood(r = 0.403,P <0.01).3.By quantifying the IOD values of Six1 protein in all patients with rectal cancer included in the study,all cases can be divided into relatively high levels of Six1 expression(high expression group n=57)and relatively low levels of Six1 expression(low Expression group n=56).Software analysis showed that the percentage of peripheral blood CEA and CA19-9 values in patients with Six1 high expression group was higher than normal,and the values were significantly higher than those in Six1 low expression group.The proportion of patients with pathological grades with moderate to low differentiation was significantly higher than that of the Six1 low-expression group,The percentages of patients with TNM stage Ⅲ and Ⅳ were more than those in the low expression group of Six1,and the percentage of patients with lymph node metastasis were still significantly higher than those in the low expression group of Six1.The above differences were significant after the χ2 test(P <0.05).At the same time,the KM survival curve analysis showed that the total survival percentage at 5 years after radical operation in the Six1 low-level group was 73.2%,and the total survival percentage at 5 years after radical operation in the relative group was 40.3%.The 5-year survival was better than the Six1 high-expression group(Log-rank χ2 = 13.590,P <0.01).4.Cox multiple regression analysis showed that Six1 was highly expressed in patients with rectal cancer(HR = 3.241,95% CI: 1.836-5.816),and peripheral blood CA19-9≥37 k U / L(HR = 1.934,95% CI: 1.612-3.423),CEA of peripheral blood ≥ 5 μg / L(HR = 3.578,95% CI: 1.984-6.148),pathological grade is low-grade differentiation(HR = 1.591,95% CI: 1.096-2.759),TNM stage is Ⅲ,Ⅳ Period(HR = 2.074,95% CI: 1.782-4.173)and the presence of lymph node metastasis(HR = 1.799,95% CI: 1.597-2.957)were independent risk factors that affected the 5-year survival rate of radical rectal cancer.Analysis of the data of the two groups through the ROC curve shows that using the IDO value of Six1 as the cutoff value of 3.145,the sensitivity of assessing the 5-year survival of patients after surgery was 83.63%,the specificity was 71.32%,and the area under the curve was 0.751,P <0.01.Conclusion The expression of Six1 protein in rectal cancer tissues is significantly higher than that of normal tissues,and it is an independent risk factor for 5-year survival rate after radical rectal cancer.The participation of Six1 protein is particularly important for tumor progression and prognosis for patients with rectal cancer.The evaluation has certain clinical reference value.