The Relationship Of Ki-67 In Advanced Colorectal Cancer With Different Primary Sites And Its Relationship With Prognosis

Purpose: This study aimed to investigate the difference of Ki-67 expression in advanced colorectal cancer with different primary sites and its prognostic value in patients with advanced colorectal cancer and its predictive value of chemotherapy.Methods: A total of 92 cases with postoperative recurrence or advanced colorectal cancer who were admitted to Department of Oncology,The First Affiliated Hospital of China Medical University from January 2010 to December 2016 were retrospectively analyzed.Among them,55 37 cases of patients who had no radical resection at the time of diagnosis were collected.The patients' gender,age,clinical stage,tumor location,pathological features,treatment methods and curative effect were collected.Patients were followed up until December 31,2017,and all patients were enrolled at the end of the study.The data obtained using COX univariate analysis,using Kaplan-Meier method to draw the survival curve,univariate analysis of statistically significant indicators of COX multivariate analysis.All statistical analysis using SPSS version 16.0.All statistical analysis with P <0.05 for the difference was statistically significant.Results: A total of 92 patients with advanced colorectal cancer were retrospectively analyzed,including 70 patients with left-sided colon cancer and 22 patients with rightsided colon cancer.The median follow-up time was 22 months(range,4-54 months).As of the end of the study A total of 76 patients experienced disease progression with a median PFS of 10 months(1-53 months).A total of 53 patients died with a median OS time of 36 months(range,4-52 months).The univariate analysis showed that the location of the tumor(P = 0.034),lymph node metastasis(P = 0.019),Ki-67 expression(P = 0.017)were correlated with the prognosis of advanced colorectal cancer PFS.The grade(P = 0.007),lymph node metastasis(P = 0.026)were associated with OS prognosis in advanced colorectal cancer.Cox multivariate analysis showed that the PFS of patients with advanced colorectal cancer was significantly higher than that of patients with advanced colorectal cancer(P = 0.014)Independent prognostic factors,and COX multivariate analysis of two outcomes with statistical significance of OS univariate analysis showed that histological grade(P = 0.025)was an independent prognostic factor for OS in patients with advanced colorectal cancer.The relative clinical and pathological features of left and right colon cancer were compared.The results showed no significant difference in gender,age,ECOG score,histological grade,T stage,N stage and best curative effect between the patients with left and right colon cancer.(P = 0.029).There were more Ki-67 overexpression in left-sided colon cancer than right-sided colon cancer(62.9% VS 36.4%).The Ki-67 overexpression Ki-67 low expression of the relevant clinical and pathological features were compared,the results showed that the two groups of patients with gender,age,ECOG score,histological grade,T stage,N stage no significant difference between the chemotherapy The best curative effect was statistically significant(P = 0.009).The Ki-67 overexpression group had the highest response to CR or PR than the Ki-67 overexpression group(27% VS 10% The patients with the best PD in the group were lower than the Ki-67 low expression group(9.6% VS 25%),and the Ki-67 high expression group had better curative effect than the Ki-67 low expression group.Conclusion: The location of tumor,lymph node metastasis,Ki-67 expression was correlated with the prognosis of advanced colorectal cancer PFS,histological grade,lymph node metastasis and prognosis of advanced colorectal cancer.Lymph node metastasis,Ki67 expression is an independent prognostic factor for PFS in advanced colorectal cancer.Histological grade is an independent prognostic factor for OS in advanced colorectal cancer.The expression of Ki-67 in left and right colon cancer was statistically different,and it was higher in left colon cancer patients than in right colon cancer patients.Ki-67 was associated with the best response to tumor chemotherapy and Ki-67 overexpression tumor chemotherapy The curative effect is better than the Ki-67 low expression group.