Expression Of Na~+,K~+-ATPase ?1 Subunit In Human Colorectal Cancer And Its Relationship To Metastasis And Prognosis

Objective: To investigate the level of Na~+,K~+-ATPase ?1 subunit expression in patients with Colorectal cancer(CRC),and to explore its relationship with clinical stages and prognostic value.Methods: In this study,we collected postoperative paraffin specimens of CRC in pathology department of Zunyi medical college affiliated hospital from December 2009 to December 2010.We tested CRC tissue samples with the immunohistochemical detection,in order to identify the distribution and expression of Na~+,K~+-ATPase ?1 subunit in CRC samples.Then we analyzed the relationship between Na~+,K~+-ATPase ?1 subunit expression and the clinic pathological features of CRC by ?~2test.Kaplan-Meier analysis was used for survival statistics,Log-rank method for the survival analysis,and Cox proportional hazards regression models were performed for univariate and multivariate survival analyses to identify the correlation between Na~+,K~+-ATPase ?1 subunit and the prognosis of the patients with CRC,P< 0.05 is statistically significant.Results: In total,29 cases of CRC patients were included in our research.According to Dukes stage,stage A 4 cases,stage B 10 cases,stage C 10 cases,stage D 5 cases.1-year,3-year,5-year survival rates of the whole group were 86.20%,65.51% and 41.37%.The results of immunohistochemical showed that Na~+,K~+-ATPase ?1 subunit expressed on difference stages of colorectal cancer,the positive rate of Na~+,K~+-ATPase ?1 subunit expression in Dukes C and D was significantly higher than Dukes A and B(80.0% vs.26.7%),statistically showed significant difference(P < 0.001),?~2 test showed that Na~+,K~+-ATPase ?1 subunit was related to Dukes stage(P=0.035)?lymph node metastasis(P=0.005)and distant metastasis(P=0.025),and Na~+,K~+-ATPase ?1 subunit was not related to tissue differentiation degree(P=0.450)of CRC;Kaplan-Meier analysis and Log-rank survival analysis showed that high expression of ?1 subunit have a poor prognostic than low expression of ?1 subunit(56 month vs.40 month)in CRC patients,statistically showed significant difference(P=0.006);univarate survival analyses showed that Na~+,K~+-ATPase?1 subunit expression level(P=0.035),Dukes stage(P=0.013),lymph node metastasis (P=0.001)and distant metastasis(P=0.019)were associated with overall survival(OS)of CRC patients(P < 0.05),while age(P=0.941),gender(P=0.055),tumor sizes(P=0.089),serum CEA levels(P=0.964)and tissue differentiation degree(P=0.648)has no significant connection with the CRC patients' overall survival(OS);multivariate survival analyses showed that the expression of Na~+,K~+-ATPase ?1 subunit and Dukes stage were independent prognosis factors for overall survival in patients with CRC(P<0.05).Conclusions: The expression of Na~+,K~+-ATPase ?1 subunit is related to the Dukes stage,lymph node metastasis and distant metastases in CRC,and is not related to the degrees of tissue differentiation in CRC;higher expression of Na~+,K~+-ATPase ?1 subunit has a poor prognostic than lower expression of Na~+,K~+-ATPase ?1 subunit in patients with CRC.Dukes stage is an independent prognostic factor in patients with CRC,and the levels of Na~+,K~+-ATPase ?1 subunit expression may be a potential predictors of patients with CRC.