Expression Of Bcl-2、TS And P27kipl And Adjuvant Chemotherapy Sensitivity And Prognosis In Patients With Postoperative Stage Ⅲ Colon Cancer

Objective: To detect the expression of Bcl-2、TS and P27kip1in stage Ⅲcoloncancer tissue, so as to explore the relationship between the expression of these threeprotein with postoperative adjuvant chemotherapy sensitivity and prognosis. It willprovide molecular biology basis for the postoperative adjuvant chemotherapy andprognosis in colon cancer.Methods: A total of81patients with stage Ⅲ colon cancer hospitalized in GeneralSurgery Department of the First Affiliated Hospital of Dalian Medical University duringJanuary2004to January2010. All patients did colonic resection and receivedpostoperative adjuvant chemotherapy. Including43male and38female, aged32-78years old, median age was60years old. We used immunohistochemical technique MaxVisionTM2/HRP method to detect the expression of Bcl-2、TS and P27kip1in tumortissue. All cases were followed up for3years, recording the disease free survival(DFS). SPSS19.0statistical software was used for statistical analysis, and P-value lessthan0.05were considered significant. Chi-square test was employed on correlationbetween the expression of Bcl-2、TS、P27kip1and clinical pathological parameters.Survival curves were produced and median survival times were estimated using themethod of Kaplan-Meier. Comparisons of the survival curves of groups were based onthe Log-rank test. Cox proportional hazards regression was used for Multivariateanalysis.Result:1、There were51cases of recurrence in all of the81colon cancer patients,3-yearDFS rate was38.3%. The positive expression rate of Bcl-2, TS and P27kip1were23.5%(19/81),58%(47/81),67.9%(55/81).2、Bcl-2expression was not correlated with adjuvant chemotherapy sensitivity (28.0%vs16.1%, P＞0.05). At the same time, the expression of Bcl-2was notcorrelated with sex, age, pathological type, histological grade, depth of invasion, thenumber of node metastasis and location of the lesion either (P＞0.05).TS expression was correlated with adjuvant chemotherapy sensitivity (68.0%vs41.9%, P=0.021) and the number of lymph node metastasis (P=0.034), but notcorrelated with sex, age, pathological type, histological grade, depth of invasion andlocation of the lesion (P＞0.05).The expression of P27kip1was not correlated with adjuvant chemotherapysensitivity (66.0%vs71.0%, P＞0.05). The expression was correlated with histologicalgrade (79.6%vs50.0%, P=0.005), pathological type (74.6%vs44.4%, P=0.016),depth of invasion (75.0%vs52.0%, P=0.041), but not correlated with sex, age, numberof node metastasis and location of the lesion (P＞0.05).3、The result of Log-rank test shows the expression of TS (P=0.044), location ofthe lesion (P=0.039), depth of invasion (P=0.048) and the number of lymph nodemetastasis (P=0.008) were associated with3-year DFS.4、Cox multivariate regression analysis shows that the depth of invasion (P=0.034,OR=1.870) and the number of lymph node metastasis (P=0.006, OR=2.584) werethe independent prognostic factors associated with stage III colon cancer after operation.Conclusion:1、TS expression was associated with the postoperative adjuvant chemotherapysensitivity of stage Ⅲcolon cancer. It can be used as a predictor of adjuvantchemotherapy effect.2、TS expression was significantly correlated with the number of lymph nodemetastasis,and the expression of P27kip1was associated with histological grade,pathological type and depth of invasion.3、TS expression was associated with the3-year DFS of stage Ⅲcolon cancer. Itcan be used as a prognostic indicator.4、The expression of TS, lesion location, depth of invasion and the number oflymph node metastasis were associated with the prognosis of stage Ⅲcolon cancer, including infiltration depth and the number of lymph node metastasis were independentprognostic factors.