Preliminary Investigation On The Expression And Clinical Value Of FSTL3 In Colorectal Cancer

Objective:Follistatin-Like protein 3(FSTL3)is highly expressed in a variety of malignant tumors and plays an important role in tumor progression.However,the specific expression of FSTL3 in colorectal cancer(CRC)and its clinical significance have not been explored in existing studies.This study investigated the expression of FSTL3 in stage III CRC and evaluated its value as a prognostic marker of CRC.Methods:Data from public databases such as GEPIA,Ualcan and Human Protein Atlas Project were used to analyze the expression of FSTL3 in CRC and the relationship between the expression level and prognosis of patients.Subsequently,the clinicopathological data of stage III colorectal cancer patients who underwent radical surgical resection from 2011 to2014 were collected by retrospective study,and the expression of FSTL3 in CRC tissues and normal adjacent tissues was obtained by immunohistochemical method.Combined with the collected clinical information and pathological data of patients,univariate and multivariate analyses were used to evaluate the relationship between the expression level of FSTL3 and clinicopathological features of patients and the impact on the prognosis of CRC patients.Finally,Hct-116 and DLD-1cells were selected for FSTL3 knockdown and overexpression.Then cell scratch test,Transwell migration test and invasion test were performed to evaluate the effect of FSTL3 on the invasion and migration ability of colorectal cancer cells in vitro.Results:Analysis of public databases such as GEPIA,Ualcan and Human Protein Atlas Project showed that FSTL3 was highly expressed in colorectal cancer tissues compared with normal adjacent tissues,and CRC patients with high FSTL3 expression had significantly worse prognosis than those with low FSTL3 expression.Immunohistochemistry showed that FSTL3 was highly expressed in CRC tumor tissue,metastatic lymph node tissue and vascular tumor plug tissue compared with paracancer tissue.There were significant differences in lymph node metastasis stage(P < 0.001),TNM substage(P=0.008),vascular tumor thrombridge formation(P=0.045)and tumor diameter(P=0.013)between the high expression group and the low expression group of FSTL3.Multivariate Cox analysis showed that tumor diameter(P=0.055),vascular tumor thrombolysis(P < 0.001)and FSTL3 expression(P=0.007)were associated with overall survival of CRC patients.Tumor diameter(P=0.029),vascular tumor thrombolysis(P < 0.001),and FSTL3expression(P=0.032)were associated with disease-free survival in CRC patients,and FSTL3 was an independent prognostic factor in CRC patients.In vitro cell tests showed that knockdown and overexpression of FSTL3 could inhibit and promote invasion and migration of HCT-116 cells and DLD-1 cells,respectively.Conclusion:1.FSTL3 is highly expressed in colorectal cancer tissues,and the high expression of FSTL3 in colorectal cancer tissues is significantly correlated with tumor diameter,lymph node metastasis,tumor substages(IIIA,IIIB,IIIC)and vascular cancer plug(IVE)in stage III CRC patients.2.Overall survival and disease-free survival of patients with high expression of FSTL3 in colorectal cancer tissues were shorter than those with low expression of FSTL3;3.In vitro cell experiments showed that FSTL3 promoted the migration and invasion of colorectal cancer cell.