Expression And Correlation Of CD44,Ki67 And Serum CA19-9 In Pancreatic Cancer

Objective:To observe the expression of CD44,Ki67 and serum CA19-9 in pancreatic cancer,and to analyze the correlation between the three and the pathological differenttiation of pancreatic cancer,TNM stage and lymph node metastasis,and furtherstudy whether the expression of the three is related and related.The relation nship between survival and prognosis.Methods:The data of 79 patients with pancreatic cancer surgery who had complete follow-up records from 2009 to 2015 were collected.As an experimental group,there were 46 males and 33 females with an average age of 55.13±14.72 years.According to the eighth edition of AJCC pancreatic cancer TNM staging criteria,the pathological sections were classified according to pathological grades,and the preserved paraffin tissues were taken.Another 60patients with non-pancreatic cancer who underwent pancreatic surgery（17 cases of islet cell tumor,23 cases of solid pseudopapillary tumor of the pancreas,8 cases of pancreatic cystadenoma,5 cases of intraductal papilloma of the pancreas,7 cases of chronic pancreatitis）As a control group,the paraffin tissue samples of the control group were selected as non-tumor tissues（2 cm away from the tumor tissue）,except for chronic pancreatitis.Each tissue sample was subjected to 10 sections of 3μm serial sections.Immunohistochemical staining of CD44 and Ki67 was performed.At least two pathologists completed the histological diagnosis.The preoperative serum CA19-9 levels of the two groups were collected.The differences of CD44,Ki67 and CA19-9 levels were compared between the two groups.The experimental groups were divided into different tumor differentiation,TNM stage and lymph node metastasis.The differences and correlations between CD44,Ki67 and serum CA19-9 levels were compared.Postoperative survival time of patients with different levels of CD44,Ki67,and CA19-9,and the correlation between CD44,Ki67,and CA19-9 levels and prognosis of pancreatic cancer were determined.Results:（1）The pancreatic cancer tissues observed under the microscope were stained,and the cancer cells were clearly formed,and most of them were oval.The cytoplasm is located at the base of the cell,mostly watery and transparent,and the cancer cells are arranged in a glandular tubular structure.The size of the glandular tube is different,the secretion of mucus is more,the interstitial fibrous tissue is more,and the lymphocytes are infiltrated a small amount.In non-pancreatic cancer tissues,the cells are relatively intact,the interstitial is obvious,and the connective tissue extends to the gland,which is divided into many small leaves,and the boundary between the leaflets is not obvious.（2）The positive expression rate of CD44 in pancreatic cancer tissues is high,and the positive staining signal is brown or brown granular,which is mainly distributed on the cell membrane of tumor cells.The positive rate of CD44 expression in the experimental group was higher than that in the control group,P<0.05,the difference was statistically significant.The expression of CD44 in pancreatic cancer tissues with different degrees of differentiation was significantly higher in the poorly differentiated cancer group than in the moderately differentiated cancer and well differentiated cancer group..P<0.05,the difference was statistically significant.Compared with the expression of CD44 in different TNM stage pancreatic cancer tissues,the results showed that the III stage group was significantly higher than the II stage group and the first stage group,and the test was P<0.05,the difference was statistically significant;The expression of CD44 in lymph node metastasis of pancreatic cancer was significantly higher in N₂ group（4 lymph node metastasis）than in N₁ group（4 lymph node metastasis）and N₀ group（no lymph node metastasis）,P<0.05.The difference was statistically significant.（3）Ki67 was clearly expressed in pancreatic cancer tissues,and the positive staining signal showed brown or brown particles,which were mainly distributed in the nucleus,and no expression was found in mesenchymal cells.The positive rate of the experimental group was significantly higher than that of the control group,P<0.05,the difference was statistically significant.The expression of Ki67 in different degrees of differentiation of pancreatic cancer tissues was significantly higher in the poorly differentiated group than in the moderately differentiated group and the highly differentiated group.P<0.05,the difference was statistically significant.The expression of Ki67 in different TNM stage pancreatic cancer tissues was compared.The results showed that the III stage group had high II stage and stage I group,but the test was P>0.05.The difference was not statistically significant,suggesting the expression of Ki67.There was no significant correlation with TNM staging of pancreatic cancer.The expression of ki67 in pancreatic cancer tissues was compared with that of different lymph node metastasis.The results showed that N2 group was significantly higher than N₁ group and N₀ group,P<0.05,the difference was statisti-cally significant.（4）The comparison of serum CA19-9 expression levels between the experimental group and the control group showed that the positive rate and numerical value of serum CA19-9 in the experimental group were significantly higher than those in the control group,P<0.05,and the difference was statistically significant.In the experimental group,the positive rate and value of serum CA19-9 in patients with different degrees of different-iation were significantly higher in the poorly differentiated group than in the moderately differentiated group and the highly differentiated group,P<0.05,the difference was statisti-cally significant;The positive rate of serum CA19-9,P>0.05,there was no significant difference between the positive rate of CA19-9 and the TNM stage.However,the value of CA19-9 was significantly higher in the III stage group than in the first stage group,and the test group was P<0.05.The difference was statistically significant.The expression of serum CA19-9 positive rate in patients with different lymph node metastasis was P>0.05,suggesting that the difference was not statistically significant,but the serum CA19-9 value of N2 group was significantly higher than that of N₁ group and N₀group.Level,P<0.05,the difference was statistically significant.（5）There was a correlation between the expression and elevation of CD44,Ki67 and serum CA19-9,which was statistically significant（P<0.05）.Correlation with prognosis of patients with pancreatic cancer found that the positive rate of CD44 and Ki67 in patients with pancreatic cancer was higher.High,the higher the level of CA19-9,the lower the postoperative survival rate.CD44,Ki67 and CA19-9 were inversely associated with surv-ival in patients with pancreatic cancer.The correlation r was-0.7848,-0.8124,-0.5978,and the test was P<0.05.The difference was statistically significant.The positive prognosis of CD44,Ki67 and CA19-9 was significantly lower than that of non-three patients.,P<0.05,the two groups were statistically significant.Conclusion:（1）CD44 levels were significantly elevated in patients with pancreatic cancer,and correlated with tumor differentiation,TNM stage,lymph node metastasis,and prognosis.（2）The high expression of Ki67 in pancreatic cancer patients was correlated with tumor differentiation,lymph node metastasis and prognosis,but had no significant correlation with tumor TNM stage.（3）The serum CA19-9 level in most patients with pancreatic cancer is correlated with the degree of tumor differentiation,TNM stage,lymph node metastasis,and it is also indirectly proved to be negatively correlated with prognosis,but the prognosis of CA19-9negative patients is not comparable with positive patients.Statistical differences.（4）There is a correlation between the expression and elevation of CD44,Ki67 and CA19-9,and the prognosis of the three patients with the same positive expression is the worst,suggesting that combined detection of CD44,Ki67,serum CA19-9 may be one of the effective means to predict the prognosis of pancreatic cancer.