The Preliminary Study Of Relationship And Significance Between Metastasis Associated In Colon Cancer 1(MACC1) And Clinicopathological Features In Colorectal Cancer

Background and objective With the development of molecular biology , it ispossible to adopt tumor tailor therapy and predict tumor prognosis according tothe molecular biological characteristics of tumor.MACC1 gene was a recentlly newdiscovered gene which was considered to play an important role in tumor process ofmetastasis .As a key regulator in HGF/Met signal pathway，MACC1 gene took partin the process of CRC carcinogenesis,progression and metastasis by controllingMETmRNA expression .In this study we investigate MACC1 expression rate inchinese CRCs’tumor tissue; demonstrate the relationship between MACC1 and clinicopathological features ;study the predit value of MACC1、MMP-2、VEGF toCRCs’prognosis and provide evidence for CRC tailor therapy.Methods An immunohistochemical approach(streptavidin-perosidase SP) was usedto detect MACC1、VEGF、MMP-2 expression in paraffin specimens from 226 CRCpatients .none of the patients received preoperative radiotherapy or chemotherapy .Survival Analysis was used to investigate the relationship between MACC1expression and prognosis in CRC;to demonstrate the espression rate of MACC1、MMP-2、VEGF and their predit values of prognosis in CRC .Results 1. The positive expression rate of MACC1,MMP-2,VEGF proteins in 226CRC patients is 42.9%, 48.7%,50.4%,respectively.2. The positive expression rate of MACC1 is closely related with tumor size,differentiation, Dukes’ stage ,vascular invasion ,age, The diferences of them havestatistical significance (p<0.05). While the expression isn’t correlated with thepatient’s sex, pathological type ,tumor location (p >0.05).3. 5-year survival rate of MACC1 positive patients is 9.28% ,while the negative is85.12%(χ2 =179.04 p=0.000).4. 5-year survival rate is 23.08% for Dukes’B patients with positive MACC1expression , with or without chemotherapy 5-year survival rate is 50% ,6.25%respectively（p＜0.05）.5．The positive and negative predictive value of MACC1 is 90.7%，85.3%respectively, the accuracy is 87.6%. the positive and negative predictive value ofMMP-2 is 54.6%，59.5% respectively, the accuracy is 57.1%. the positive andnegative predictive value of VEGF is 54.4%，59.8% respectively, the accuracy is57.1%.6．The risk factors for colorectal cancer prognosis contains Dukes’ stage ,MACC1expression ,vascular invasion,the relative risk(RR) value is 4.511,10.745, 2.299 respectively,while chemotherapy is a protective factor, RR value is 0.418.Conclusion 1. MACC1 expression rate is 42.9% in chinese CRC ,the positiveexpression rate is associated with increased tumor size, differentiation, Duke’s stage,vessel invasion and age, the rate is higher in young patients with large leision,poordifferentiation,advanced stage .MACC1 positive patients have poorer prognosiscompared with negative patients2. MACC1 positive patients in Dukes’B stage have poor prognosis ,these patients canreceive suivival benefit from adjuvant chemotherapy ;MACC1may becme a indicatorof adjuvant chemotherapy for Dukes’B stage,it is worthy of further study .3. According to Cox multivariate analysis,Dukes’ stage ,MACC1 expression andVascular invasion are independent prognostic risk factors of CRC , adjuvantchemotherapy can improve prognosis of Patients with high risk factors.4. The expression rate of MACC1、MMP-2、VEGF affect the prognosis of CRC .prognostic predict value of MACC1 is better than MMP-2, VEGF . Three combinedcan improve the prediction accuracy of the prognosis of CRC.