The Correlation Analysis Of Prognostic Factors In The Expression Of Ki-67 And Microsatellite Instability In Stage ? And ? Rectal Cancer

Objective:Ki-67 is a marker of cell proliferation.Microsatellite instability is closely related to tumorigenesis.The purpose of this review is to investigate the effect of Ki-67 and microsatellite status on the prognosis of patients with rectal cancer after operation.Method:A retrospective analysis was made on 268 rectal cancer patients who underwent radical surgery(including laparoscopic surgery and laparotomy)in the same medical group of colorectal and anal surgery in the Second Hospital of Jilin University from January 2013 to December 2017.The statistical contents included gender,age,date of operation,pathological stage,histological type and immunohistochemical indexes.The immunohistochemical indexes included P53.Ki-67,BRAF V600E(VE1),PMS2,MLH1,MSH6,MSH2.The data and follow-up results involved in this study were analyzed by SPSS 22.0 software.The results included clinicopathological analysis and survival analysis.In order to confirm the accuracy of immunohistochemical results in the cases,30 cases of pathological tissue wax were randomly sampled from the pathology department of the researcher for re-examination,and the immunohistochemical operation was re-performed.The results were checked and re-checked with the pathological reports in the cases.Result:As of December 31,2017,268 cases were counted out.37 cases were excluded due to incomplete original data and lost follow-up.231 cases were included in the criteria,33 cases relapsed(survival with tumors)and 48 cases died.A total of 55 cases were followed up for 3 years,including 13 cases died and the 3-year overall survival rate was 76.36%.144 cases were followed up for 2 years,30 of them died and the 2-year overall survival rate was 79.16%.All patients were followed up for at least one year,of which 48 cases died and the 1-year overall survival rate was 79.22%.1.There were significant differences in RFS survival rates among different N stages,BRAF,Ki-67 and microsatellite status groups(P < 0.05).2.There was no significant difference in RFS survival rate among different age,sex,differentiation,T stage,histological type and root lymph node of inferior mesenteric artery(P > 0.05).3.Ki67: The relative mortality risk of high expression group(positive rate(>50%)was 7.878 times higher than that of low expression group(positive rate < 50%)(P=0.042).4.MSI: In stage II rectal cancer patients,the prognosis of MSI was better than that of MSS(P=0.034),and there was no significant difference between MSI and MSS in stage III patients(P=0.489).5.BRAF: BRAF has a significant effect on the survival rate of RFS(P=0.006).The relative risk of recurrence and metastasis in BRAF mutation patients is 2.553 times higher than that in BRAF non-mutation patients.Conclusion: 1.Ki-67 staging is the prognostic factor of rectal cancer,and the prognosis of high expression group is worse.2.The prognosis of stage II MSI group was better than that of MSS group.3.N staging is a prognostic factor of rectal cancer,which is negatively correlated with its prognosis.4.BRAF mutation is a prognostic factor of rectal cancer,and the prognosis of BRAF patients is worse.