| Objective:This study focuses on the SATB2(Special AT Rich Sequence-Binding Protein 2)and CK20(Cytokeratin 20)expression in colorectal cancer(CRC)tissue,the correlation between the expression and clinical pathological characteristics of colorectal cancer,the correlation between the expression and the prognosis of patients with colorectal cancer as well as the internal correlation of the two proteins,in order to explore the clinical significance and predictive value for prognosis of SATB2 and CK20 expression in colorectal cancer,thus to provide theoretical evidence for clinical diagnosis,prognosis prediction and targeted therapy of colorectal cancer.Methods :During July 2014 to May 2016,the rectal cancer tissue from colorectal cancer patients who accecpted surgical resection with pathology diagnosis of CRC in the General Surgical Ward of the First Affiliated Hospital of Henan University were included in this study.Paraffin-embedded specimens of tumor tissues and normal tissues adjacent to cancer that were more than 5 centimeter away from the edge of the primary tumor lesion were collected as the experimental group and the control group.All patients had complete clinical and pathological data,with no radiotherapy,chemotherapy or targeted therapy history before surgery.Postoperative follow-up was conducted through outpatient review and telephone call for 3 years.The expression levels of SATB2 and CK20 proteins in experimental and control samples were detected by immunohistochemical staining.Statistical analysis:(1)SPSS20.0 and SAS9.3 software was used for data cleaning and statistical analysis.(2)The statistical description was made for patients characteristics with mean and standard error for continual variables and frequency and percent for binary variables.The relationship between the expression of SATB2 and CK20 in tumor tissues and the clinicopathological characteristics,the correlation of expression between the two proteins,as well as the correlation between the expression of SATB2 and CK20 and the 3-year survival rate in CRC patients was analyzed by Chi-Square test or Fisher’s exact probability test.(3)A multivariate COX regression model was established for postoperative survival of CRC patients,and independent influencing factors were screened out by stepwisemethod.Kaplan-Meier method and Log-Rank test were then used to analyze the difference in survival time of CRC patients with different influencing factors.Results:1、The positive rate of SATB2 in CRC tissues was 60.84%(87/143),which is statistically significantly lower than that in normal tissue adjacent to the primary lesion(87.41%(125/143)(P < 0.05).While the positive rate of CK20 in CRC tissues was 86.01%(123/143),which is statistically significantly higher than that in normal tissue adjacent to the primary lesion(47.55%(68/143)(P < 0.05).2、There is no statistically significant correlation between the expression level of SATB2 with gender(P=0.552),age(P=0.996)or distant metastasis(P=0.196).However,expression level of SATB2 was significantly correlated with tumor diameter(P=0.027),invasion depth(P=0.015),differentiation degree(P=0.023),lymph node metastasis(P=0.028)and TNM stage(P=0.019).The expression level of CK20 was not statistically significantly correlated with gender(P=0.074),age(P=0.066),lymph node metastasis(P=0.122),distant metastasis(P=0.641)or TNM stage(P=0.911).However,it was statistically significantly correlated with tumor diameter(P=0.007),differentiation degree(P=0.009)and infiltration depth(P=0.047).3、 According to the cox regression analysis of possible influential factors for CRC prognosis,the differentiation degree(P=0.029),distant metastasis(P< 0.001),TNM stage(P< 0.001),SATB2(P=0.003)and CK20(P=0.003)expressions were statistically significantly correlated with the 3-year survival of CRC patients.However,there was no significant correlation between gender,age,tumor diameter,infiltration degree,lymph node metastasis and 3-year survival,(All P values were > 0.05).And the multivariate COX regression analysis showed the risk of death in patients with distant metastasis was 2.158 times that of whom without,and risk of patients with TNM stage for Ⅲ + Ⅳ was 2.598 times that of whose stage wasⅠ+Ⅱ.And the death risk in the SATB2 positive group was 0.496 times that of the negative group while the risk of deterioration in the CK20 positive group was 13.012 times that of the negative group.4、Survival analysis through Kaplan-Meier method and Log-Rank test showed that the average survival time of CRC patients with distant metastasis was significantly lower than that without and the difference was statistically significant(P<0.001),and survival time of patients with TNM stage for Ⅲ + Ⅳwas significantly lower than that with Ⅰ+Ⅱ stage,the difference was also statistically significant(P <0.001).At the same time,average survival time in SATB2 negative group was significantly lower than that in SATB2 positive group,and the difference was statistically significant(P = 0.003).The mean survival time of patients in the CK20 positive group was significantly lower than that in the CK20 negative group,and the difference was also statistically significant(P = 0.003).Furthermore,subgroup analysis showed that the mean survival time(28.726 months)of CK20 positive and SATB2 positive patients was significantly higher than that of the CK20 positive and SATB2 negative patients(19.992 months),and the difference between the two subgroups was statistically significant(P<0.001).5、Chi-Square test showed that there was statistically correlation between the expressions of SATB2 and CK20 in CRC tissues(χ2=4.238,P=0.040).Conclusions:1、Positive expression rate of SATB2 in colorectal cancer tissues was obviously lower than that of normal tissue,and with the increase of tumor diameter,the decrease of differentiation degree,the infiltration depth deepening,the metastasis to lymph node and the progress of TNM stage,the positive expression rate of SATB2 declineds.2、The positive expression rate of CK20 in colorectal cancer tissues was significantly higher than that in normal tissues.With the increase of tumor diameter,the decrease of differentiation degree and the progress of infiltration depth,the positive expression rate of CK20 showed an increasing trend.3、Distant metastasis,TNM stage,as well as the expression levels of SATB2 and CK20 in colorectal cancer can serve regarded as independent predictive factors for CRC prognosis.4、There was a correlation between the expression of SATB2 and CK20 in colorectal cancer tissues. |
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