Expression Of Doublecortin-like Kinase 1 In Lung Adenocarcinoma Tissue And Its Correlation With Prognosis

Purpose: Doublecortin and Ca M kinase-like-1(DCLK1)regulates microtubule polymerization of migratory neurons.Recent studies have shown that DCLK1 can be used as a marker of intestinal cancer stem cells,and it has been found to be expressed in tumor cells and stroma cells in some cancers.For example,breast cancer,colon cancer,pancreatic cancer and prostate cancer.In this research,immunohistochemical staining was used to study the expression of DCLK1 in lung adenocarcinoma and its relationship with the clinicopathological features and prognosis of the patients.Methods: The clinical pathological data and specimens of 59 patients with lung adenocarcinoma who underwent lobectomy and mediastinal lymph node dissection were collected from the First Hospital of China Medical University between June2014 and December 2014.We detect the expression of DCLK1 in lung cancer cells and stromal cells by immunohistochemical staining method.Application of Chi square test verified the correlation of DCLK1 protein expression and clinical pathological features.Survival curves were described by the Kaplan-Meier method and compared by the Log-rank test.Univariate and multivariate analysis was performed with the Cox proportional hazard model.Results: Of the 59 patients with lung adenocarcinoma,32(54.2%)had positive expression of DCLK1 cancer cells.The positive expression of DCLK1 in the tumor stromal cells has a higher ratio.The positive expression of DCLK1 in cancer cells is significantly related to the tumor T staging(P<0.001),visceral pleura invasion(P=0.001)and Ki-67 expression(P=0.020).Kaplan-Meier analysis showed that the positive expression of DCLK1 in cancer cells was significantly correlated with the4 year survival rate(P =0.019)and the 4 year relapse free survival rate(P <0.001).The positive expression of DCLK1 in tumor stromal cells was also significantly related to the 4 year survival rate(P =0.007)and the 4 year relapse free survival rate(P =0.005).Cox model analysis showed that the positive expression of DCLK1 in tumor stromal cells was the independent prognostic factor of overall survival and relapse free survival in lung adenocarcinoma patients(P = 0.013).Conclusion: The expression of DCKL1 in the tumor cells of lung adenocarcinoma is related to the T staging of lung adenocarcinoma,the invasion of the pleura and the expression of Ki-67 in tumor cells.DCLK1 may be involved in the progression of the pathological T staging of lung adenocarcinoma,and may be associated with the proliferation of tumor cells in lung adenocarcinoma.There was no difference in the expression of DCLK1 in the different pathological subtypes of lung adenocarcinoma.The positive expression of DCLK1 in the stromal cells of lung adenocarcinoma is an independent risk factor for the prognosis analysis of the patients with lung adenocarcinoma.