中性粒细胞与淋巴细胞比值联合检测纤维蛋白原对结直肠癌预后的判断价值

目的: 探讨中性粒细胞与淋巴细胞比值(NLR)和纤维蛋白原(Fibrinogen,FIB)联合形成指标FIB-NLR 在结直肠癌预后中的临床意义。方法:回顾性分析我院2010 年6 月至2011 年6 月接受手术治疗的250 例结直肠癌患者的临床资料,分别分析NLR 和FIB 与结直肠癌的病理特征的关系,将NLR 与FIB 进行联合形成一个指标(FIB-NLR)。将250 名结直肠癌患者分为3 组,患者NLR逸2.95 及FIB逸348 mg/ dl 定为FIB-NLR 2 分组,NLR逸2.95 及FIB<348 mg/ dl 或者NLR<2.95 及 FIB逸348 mg/ dl 定为1 分组,NLR<2.95 及FIB<348 mg/ dl 为0 分组,并分析3 组患者在结直肠癌的浸润深度、分期、淋巴结转移、神经浸润、远处转移、组织学分级中是否具有差异性。并将3 组患者按生存时间做生存分析,并对3 组患者的生存率进行比较。结果:中晚期及有淋巴结转移结直肠癌患者NLR 值明显高于分期较早及无淋巴结转移患者的NLR,差异具有统计学意义(P<0.001),肿瘤浸润深度较深、有神经浸润、有远处转移的患者其NLR 值明显高于浸润深度较浅、无神经浸润、无远处转移患者的NLR 值,差异具有统计学意义(P =0.006、P =0.002、P =0.007)。中晚期、有淋巴结转移、有远处转移的结直肠癌患者其FIB 值明显高于早期及无淋巴结转移、无远处转移的结直肠癌患者的FIB 值,差异具有统计学意义(P<0.001),浸润深度越深及有神经浸润的结直肠癌患者FIB 值明显高于浸润深度浅及无神经浸润患者的FIB 值,差异具有统计学意义(P =0.015、P=0.012)。NLR 与FIB 均在肿瘤的组织学分级、年龄大小、性别肿瘤部位无明显关联(P>0.05)。结直肠癌的临床分期越晚、浸润深度越深、有淋巴结转移、有远处转移、有神经浸润的患者其FIB-NLR 评分较早期、浸润深度浅、无淋巴结转移及无远处转移、无神经浸润患者高,差 异具有统计学意义(P<0.001)。生存分析发现,评分越高组其5 年生存率越低,差异具有统计学意义(P =0.001)。结论:FIB-NLR 可能是一个潜在的判断结直肠癌进展及预后的有效指标。     

叉头框M1在结直肠癌中的表达及临床意义

目的探讨叉头框M1(FOXM1)在结直肠癌中的表达及与临床病理特征、预后的关系。方法采用免疫组化SP法检测297例结直肠癌组织和80例对应癌旁正常组织中FOXM1的表达;Western blot法检测20例新鲜结直肠癌组织及对应癌旁组织中FOXM1的表达。结果 FOXM1在结直肠癌组织中的阳性率(70.97%)显著高于癌旁组织(17.50%,P0.01);FOXM1表达与结直肠癌浸润深度、淋巴结转移、脉管内癌栓转移、远处转移和TNM分期有关(P0.05);与患者年龄、性别、肿瘤部位、大小、分化程度、CEA、CA199等无关(P0.05)。结直肠癌组织中FOXM1蛋白相对表达量(0.855±0.063)明显高于相应癌旁组织(0.150±0.041,P0.01)。FOXM1阳性患者的3年生存率明显低于阴性患者(P0.01),且FOXM1为结直肠癌预后的独立性危险因素。结论 FOXM1蛋白在结直肠癌组织中过表达,且与患者临床病理特征、预后等因素有关,可能在结直肠癌的发生、转移等过程中起重要作用,有望成为结直肠癌新的肿瘤标志物和潜在的治疗靶点。     

术前血清CEA在结直肠癌患者预后判断上的作用

目的研究术前血清癌胚抗原(CEA)在判断结直肠癌患者预后中的价值。方法 426例结直肠癌患者按术前CEA水平分为两组:CEA正常组(﹤5ng/mL)和CEA升高组(≥5ng/mL)。跟踪随访上述病例并分析相关临床病理学指标同预后的关系。结果术前血清CEA水平与结直肠癌患者肿瘤大小、浸润深度、淋巴结转移及临床分期密切相关。血清CEA升高组患者的总生存期和无进展生存期明显低于CEA正常组(P<0.001,P<0.001)。单因素及多因素回归分析证明,术前血清CEA水平为判断结直肠癌患者预后的独立指标。结论血清CEA可为结直肠癌患者预后判断提供重要的临床参考依据。     

RhoGDI2在结直肠癌中的表达及临床意义

目的：探讨RhoGDI2在结直肠癌中表达及临床意义。方法：通过免疫组化检测 RhoGDI2 在结直肠癌组织、癌旁组织及转移淋巴结中表达,分析其与CRC患者临床因素及生存期之间的关系。结果：RhoGDI2在癌旁组织、肿瘤原发灶及转移淋巴结中表达逐渐升高,差异有统计学意义（P＜0.001）; RhoGDI2表达与淋巴结转移、远处转移关系密切（P＜0.05）;高表达RhoGDI2者总生存期及无病生存期短。结论：RhoGDI2在结直肠癌组织中高表达,且与结直肠癌淋巴结转移、远处转移明显相关,高表达RhoGDI2者总生存期及无病生存期短。     

乳腺癌中CD66b阳性肿瘤相关中性粒细胞的意义

目的 探讨CD66b阳性肿瘤相关中性粒细胞在乳腺癌中的浸润及意义。方法 收集安徽医科大学第一附属医院病理科存档的80例乳腺癌手术切除组织,采用免疫组化SP法观察中性粒细胞的浸润情况,Graphpad软件分析其临床病理特征;下载TCGA数据库,R软件分析乳腺癌中肿瘤相关中性粒细胞的浸润及其与预后的相关性。结果 80例乳腺癌组织中,肿瘤相关中性粒细胞的浸润密度与无瘤生存期呈负相关(P=0.007 7),与肿瘤病理分期(P=0.005 0)、淋巴结转移(P=0.023 7)、远处转移呈正相关(P=0.001 0),与三阴型乳腺癌相关(P=0.012 0);TCGA数据库显示,肿瘤相关中性粒细胞的数量与淋巴结侵犯(P=0.037 0)、远处转移相关(P=0.013 0)。结论 乳腺癌组织中CD66b阳性肿瘤相关中性粒细胞可作为潜在的转移预测指标。     

胃癌中CMTM6和PD-L1的表达及其临床意义

目的 探讨CMTM6和PD-L1在胃癌中的表达及其与临床病理特征、预后的关系。方法 收集103例胃癌患者的临床资料，采用免疫组化MaxVision两步法检测胃癌组织中CMTM6和PD-L1的表达，分析两者表达与临床病理特征的关系。结果 103例胃癌组织中CMTM6高表达70例(68.0%),低表达33例(32.0%);PD-L1高表达66例(64.1%),低表达37例(35.9%)。正常胃黏膜组织中CMTM6高表达39例(37.9%)、低表达64例(62.1%);PD-L1高表达35例(34.0%)、低表达68例(66.0%);两组相比差异有显著性(P<0.001)。CMTM6表达与肿瘤分化程度、浸润深度、脉管浸润、淋巴结转移、远处转移、TNM分期和PD-L1表达相关(P<0.05)。PD-L1表达与患者性别、脉管浸润、神经侵犯和TNM分期相关(P<0.05)。Kaplan-Meier生存分析表明，CMTM6高表达与胃癌患者不良预后相关(P=0.008)。Cox单因素生存分析显示，胃癌患者的预后与肿瘤最大径、浸润深度、脉管浸润、远处转移、淋巴结转移、TNM分期和CMT...     

影响乳腺浸润性导管癌腋窝淋巴结转移因素的有序Logistic回归分析

目的探讨乳腺浸润性导管癌腋窝淋巴结转移的影响因素。方法连续回顾分析1 005例乳腺浸润性导管癌的临床病理资料,按淋巴结转移率将其分成低、中、高三个淋巴结癌转移程度,采用有序Logistic回归,分析淋巴结转移是否与年龄、肿瘤大小、分子亚型、脉管癌栓、神经侵犯、肿瘤组织学分级、Ki-67、ER、PR、EGFR、HER-2、COX2等因素有关。结果单因素分析结果显示,乳腺浸润性导管癌淋巴结转移程度与肿瘤大小、脉管癌栓、神经侵犯、肿瘤组织学分级有关(P值分别为0.001、0.001、0.001、0.007)。多因素有序Logistic回归分析表明,肿瘤大小(β=0.309,P0.001)、脉管癌栓(无相对于有,β=-1.314,P0.001)、神经侵犯(无相对于有,β=-0.713,P0.001)是影响淋巴结癌转移程度的独立因素,其中脉管癌栓是主要影响因素。结论乳腺浸润性导管癌腋窝淋巴结转移程度可能与肿瘤大小、脉管内癌栓、神经侵犯、肿瘤组织学分级等有关,肿瘤大小、脉管癌栓、神经侵犯是独立的影响因素,其中脉管癌栓可能是主要的影响因素,神经侵犯次之。     

结直肠癌原发灶及肝脏转移灶中TMSG-1的表达及意义

目的探讨肿瘤转移抑制基因(tumor metastasis suppressor gene-1,TMSG-1)在结直肠癌组织及对应肝脏转移灶中的表达,并分析其与临床病理特征的关系。方法采用免疫组化SP法检测200例结直肠癌原发灶和52例肝脏转移灶中TMSG-1蛋白的表达。结果结直肠癌原发灶中TMSG-1的高表达率为42. 5%(85/200),中等强度表达率为29. 5%(59/200),阴性率为28. 0%(56/200)。结直肠癌肝脏转移灶中TMSG-1的高表达率为17. 3%(9/52),中等强度表达率为50. 0%(26/52),阴性率为32. 7%(17/52)。TMSG-1在结直肠癌原发灶中的表达与肿瘤分化程度、浸润深度、有无淋巴结转移、有无远处转移及肿瘤TNM分期显著相关(P 0. 05),与患者年龄、性别及肿瘤大小无关。TMSG-1在结直肠癌肝脏转移灶中的表达显著低于原发灶(P 0. 05),且在肝脏转移灶中的表达与临床病理特征无明显相关性。结论 TMSG-1在肿瘤转移过程中表达明显降低,其低表达与结直肠肿瘤进展密切相关,有望在病理诊断中作为一种新型肿瘤标志物判断结直肠癌的预后。     

胃癌中骨桥蛋白、结缔组织生长因子的表达及其意义

目的 探讨骨桥蛋白(osteopontin,OPN)和结缔组织生长因子(connective tissue growth factor,CTGF)及其联合检测在判断胃癌患者预后中的意义.方法 应用免疫组化PowerVision法检测108例胃癌组织中OPN及CTGF的表达,分析OPN、CTGF表达与患者临床病理特征、术后生存时间之间的关系.结果 TNM III/IV期患者中OPN阳性率高于Ⅰ/Ⅱ期(P<0.001),OPN阳性的患者更易发生淋巴结转移(P=0.002)和远处转移(P=0.022),并且OPN表达与肿瘤浸润深度正相关(P=0.015).CTGF高表达常见于发生淋巴结转移的病例(P=0.038).OPN阳性的患者术后5年生存率低于OPN阴性的患者(P<0.001).高表达CTGF的患者术后5年生存率低于低表达CTGF的患者(P=0.003).分析联合检测OPN和CTGF在胃癌组织中的表达发现OPN阳性/CTGF高表达组、OPN阳性/CTGF低表达或者OPN阴性/CTGF高表达组与OPN阴性/CTGF低表达组3组之间患者的术后生存率存在显著差异(4.2%、34.1%、60.5%,P<0.001).Cox回归分析结果表明TNM分期(P<0.001)、分化程度(P=0.01)和OPN/CTGF联合表达水平(P<0.001)是胃癌患者的独立预后因子.结论 组织中OPN、CTGF表达与胃癌的生物学特征密切相关,尤其是联合检测OPN/CTGF两种蛋白是指示胃癌患者预后的独立指标.     

HMGB1在III期直肠癌患者肿瘤组织中的表达及与预后的关系

目的探讨高迁移率组蛋白B1(HMGB1)与III期直肠癌患者临床病理特征及术后3年无疾病生存(DFS)的关系。方法选取我院2011年2月至2015年12月诊治的III期直肠癌术后患者组织标本46例,免疫组化方法检测组织中HMGB1蛋白的表达情况,随访患者术后3年DFS。结果HMGB1在直肠癌组织中高表达24例,占52.2%,在癌旁组织中高表达10例,占21.7%,差异有统计学意义(χ2=9.144,P=0.002)。HMGB1的表达与III期直肠癌患者年龄、性别、手术方式、是否存在脉管癌栓或神经侵犯、pT分期、术前CEA水平、肿瘤生长类型无关,与pN分期、肿瘤分化程度、是否合并癌结节有关。46例III期直肠癌患者术后3年复发22例,总DFS率为52.2%,单因素分析显示HMGB1、分化程度、脉管癌栓或神经侵犯、术前CEA水平、pN分期与预后有关。多因素分析显示分化程度和术前CEA水平为独立预后因素。结论HMGB1的表达与III期直肠癌pN分期、肿瘤分化程度、是否合并癌结节有关。HMGB1高表达可能是III期直肠癌患者术后3年DFS的不利影响因素,但尚不能作为独立预后因素,检测HMGB1的表达对预后判断有一定的价值。     

Quantitative measurement of venous invasion of colorectal cancer with metachronous liver metastasis

Aims: Many studies have proven the importance of venous invasion in colorectal cancer with synchronous liver metastasis. The aim was to clarify the relationship between venous invasion and metachronous liver metastasis, which is not fully understood. Methods and results: A histological study of venous invasion in colorectal carcinoma was performed using a total of 156 patients, of whom 52 survived without recurrence for 5 years (Group A); 47 had metachronous liver metastasis (Group B), and 57 had synchronous liver metastasis (Group C). The number and the maximum area of venous invasion were estimated in each case per ×40 field of cancerous lesions, which were divided into intramural and extramural lesions. A high incidence and high average number of foci of venous invasion appeared in Groups B and C. The average maximum areas of extramural venous invasion were much larger in Groups B and C than in Group A. Conclusions: The average number of foci of venous invasion by colorectal cancer with metachronous liver metastasis did not differ significantly from that with synchronous ones. Furthermore, invasion into extramural large veins appeared to be associated with liver metastasis.     

The fibrotic focus in advanced colorectal carcinoma: a hitherto unrecognized histological predictor for liver metastasis

 A fibrotic focus (FF) is a clearly defined area consisting of fibroblasts and/or collagen fibres arranged in irregular or storiform patterns within tumours. We looked to see whether FF in advanced colorectal carcinoma was associated with distant organ metastasis especially to the liver. The correlation between FF and the presence of synchronous or total (synchronous and/or metachronous) liver metastasis and tumour recurrence was assessed in 77 patients with Dukes B and C advanced colorectal carcinoma treated by resection. The median follow-up period was 21 months. In multivariate analysis, FF significantly increased the relative risk (RR) of synchronous liver metastasis (RR=4.9, P<0.05) and total liver metastasis (RR=4.6, P<0.05). FF also increased the RR of tumour recurrence (RR=2.4), but the increase was not statistically significant. FF is a newly recognized histological indicator of liver metastasis in advanced colorectal carcinoma. Received: 26 March 1998 / Accepted: 20 July 1998     

肿瘤干细胞标志物LGR5及ALDH1在卵巢癌组织中的表达及临床意义

目的 探讨肿瘤干细胞标志物含亮氨酸重复序列G-蛋白偶联受体5(1eucine-rich repeat-containing G protein coupled receptor 5,Lgr5)及乙醛脱氢酶1(aldehyde dehydro-genase 1,ALDH1)在卵巢癌中的表达与临床意义.方法 选取2006年5月至2010年1月住院并接受手术治疗的卵巢癌患者140例,选取同期本院因卵巢良性病变行肿物剥除或附件切除的40例患者作为对照,应用免疫组化(S-P)方法检测140例卵巢癌组织(卵巢癌组)、140例卵巢癌癌旁组织(癌旁组)、正常卵巢组织40例(正常组)中的Lgr5及ALDH1蛋白表达,分析其与卵巢癌患者临床病理指标的关系.结果 (1)Lgr5在正常卵巢组织、癌旁组织和卵巢癌中的阳性率(5.0% vs 18.3% vs 95.7%)差异具有统计学意义(P=0.001);ALDH1在正常卵巢组织、癌旁组织和卵巢癌中的阳性率(7.5% vs 15.7% vs 90.0%)差异具有统计学意义(P<0.05).(2)Lgr5表达与肿瘤分化程度、淋巴结转移及TNM分期有关(P<0.05).ALDH1表达与肿瘤分化程度、浸润深度、淋巴结转移及TNM分期有关(P<0.05).(3)Lgr5及ALDH1存在正相关性(r=0.3,P<0.05).(4)Lgr5高表达者(+++)和低表达者(+)~(++)5年总生存率分别为51.2%和29.2%(HR=11.637,95%CI:4.351~38.213;P=0.002);ALDH1高表达者(+++)和低表达者(+)~(++)5年总生存率分别为41.3%和35.3%(HR=10.143,95%CI:4.285~33.275;P=0.006)..多因素Cox回归分析显示,Lgr5蛋白(+++)表达(P=0.002)、ALDH1蛋白(+++)表达(P=0.006)、分化程度(P=0.036)、浸润深度(P=0.001)和远处转移(P=0.002)是影响胃癌患者预后的独立因素.结论 Lgr5及ALDH1的增强表达与卵巢癌侵袭性增强有密切关系,其表达可作为判断卵巢癌患者预后的指标.     

Human leukocyte antigen G expression: as a significant prognostic indicator for patients with colorectal cancer.

Aberrant expression of human leukocyte antigen G (HLA-G) has been proposed to be involved in tumor escape mechanisms. It has been also proposed that detection of HLA-G might service as a potential biomarker for diagnosis or prediction of the clinical outcomes in ovarian and breast cancers, carcinoma of the lung and endometrial cancer. The aim of this current study is to determine if HLA-G is expressed in colorectal carcinomas and if the expression is associated with clinicopathological and prognostic data. The expression of HLA-G was investigated immunohistochemically in 201 patients with colorectal carcinomas. The correlation between HLA-G status, clinicopathological factors and the overall survival rate was analyzed. In this prospectively study, HLA-G protein expression was observed in 64.6% (130/201) of the primary site colorectal carcinomas, but not in the normal colorectal tissues or benign adenomas. HLA-G expression in the tumors was significantly correlated with the depth of invasion, histological grade, host immune response, lymph nodal metastasis and clinical stages of the disease (P=0.001, 0.0001, 0.002, 0.001 and 0.031, respectively). Patients with HLA-G positive tumors had a significantly shorter survival time than those patients with tumors that were HLA-G negative (P=0.0001). As well, in multivariate analysis, HLA-G demonstrated an independent prognostic factor (P=0.021, relative risk 3.14; 95% confidence interval, 1.34-8.10). Therefore, it can be gathered that HLA-G might serve as an independent prognostic factor for colorectal cancer patients.     

Significance of an insular component in follicular thyroid carcinoma with distant metastasis at initial presentation

Risk factors for distant metastasis were studied in 82 patients with follicular thyroid carcinoma (FTC). Metastases to either the lung or bone existing at the time of presentation were confirmed by I-131 radio-iodine uptake in 10 patients. FTC with an insular component was found in eight patients. Univariate analysis of 14 possible risk factors showed 7 to be statistically significant: insular component, poorly differentiated carcinoma, trabecular component, serum thyroglobulin level before surgery, patient age at the time of presentation, solid component, and vascular invasion (ranked by p values). After further analysis of the interrelation of the factors and of the logistic regression curves, we concluded that presence of an insular component and patient age were the only independent risk factors. Distant metastasis was not detected in any of the 27 patients ≤49 yr old. Among the 55 older patients (≥50 yr old), 5 of the 49 (10%) without an insular component and 5 of the 6 (83%) with an insular component had distant metastasis. The remaining older patient with an insular component but without distant metastasis showed a gradual increase in thyroglobulin levels after total thyroidectomy.     

血管内皮细胞生长因子和血管生成与胃癌发展的关系

目的探讨血管内皮细胞生长因子（ＶＥＧＦ）和血管生成与胃癌发展的关系。方法应用免疫组织化学和原位分子杂交技术,检测５６例人胃癌组织ＶＥＧＦ蛋白表达和微血管密度（ＭＶＤ）及部分胃癌ＶＥＧＦｍＲＮＡ表达,分析ＶＥＧＦ和ＭＶＤ、及其与胃癌组织学分型、浸润深度、生长方式、淋巴结转移、远处转移和预后的关系。结果ＶＥＧＦ阳性者ＭＶＤ值显著高于阴性者（Ｐ＜００１）,ＶＥＧＦ表达和ＭＶＤ与胃癌浸润深度（Ｐ＜００１）、淋巴结转移（Ｐ＜００５）和远处转移（Ｐ＜０．０５）密切相关,而与组织学分型和生长方式无关（Ｐ＞００５）;ＶＥＧＦ表达阳性或ＭＶＤ≥４３的胃癌患者５年生存率较低;ＶＥＧＦｍＲＮＡ表达与ＶＥＧＦ蛋白表达具有一致性,但其分布不同。结论ＶＥＧＦ与胃癌的血管生成密切相关,对胃癌的生长和浸润转移有促进作用,ＶＥＧＦ和ＭＶＤ可作为反映胃癌生物学行为的指标之一     

Association of trypsin expression with tumour progression and matrilysin expression in human colorectal cancer

Overexpression of the matrix serine protease (MSP) trypsin has been implicated in tumour growth, invasion, and metastasis. The objective of this study was to clarify the clinicopathological and prognostic significance of trypsin expression in colorectal cancer. This study analysed the association between immunohistochemically detected trypsin expression in colorectal cancer and clinicopathological characteristics, and investigated whether trypsin is a predictor of recurrence and/or survival. Trypsin immunoreactivity was more intense at the invasive front than in the superficial part of the tumour. Sections with immunostaining signals in more than 30% of carcinoma cells at the invasive front, which were observed in 48 cases (48%), were judged to be positive for trypsin. Trypsin positivity was significantly correlated with depth of invasion, lymphatic and venous invasion, lymph node and distant metastasis, advanced pathological tumour-node-metastasis (TNM) stage, and recurrence. Patients with trypsin-positive carcinoma had significantly shorter overall and disease-free survival periods than did those with trypsin-negative carcinoma. Trypsin retained its significant predictive value for overall and disease-free survival in multivariate analysis that included conventional clinicopathological factors. It is well known that trypsin activates matrilysin (matrix metalloproteinase-7), which plays an important role in colorectal cancer progression. Patients with concordant overexpression of trypsin and matrilysin at the invasive front, in which they were often co-localized, had the worst prognosis. Trypsinogen-1-transfected HCT116 colon cancer cells showed not only trypsin activity, but also active matrilysin activity and were more invasive in vitro than mock-transfected HCT116 cells. These results suggest that trypsin plays a key role in the progression of colorectal cancer. Detection of trypsin expression as well as matrilysin is useful for the prediction of recurrence in and poor prognosis of colorectal cancer patients.     

Expression of Wntless in colorectal carcinomas is associated with invasion,metastasis, and poor survival

Wntless also known as WLS, GPR177, or Evi, is a key modulator of Wnt protein secretion. Its overexpression is found in certain types of human cancers such as malignant astrocytoma and breast cancers. We hypothesized that this protein may be aberrantly expressed in colorectal carcinoma which also possesses aberrant Wnt signaling. To investigate the association between the expression of Wnt and clinicopathological parameters in colorectal carcinomas, a set of colorectal carcinoma tissue samples was analyzed for the expression of WLS using an anti‐GPR177 monoclonal antibody specific for the WLS protein. High expression of WLS protein was observed in most colorectal carcinoma samples compared with nontumor mucosa in the same patients (117/201, 58.2%). High expression of WLS was associated with sex (p = 0.005), age (p = 0.009), depth of invasion (p < 0.001), lymph node metastasis (p = 0.026), and tumor‐node‐metastasis (TNM) stage (p = 0.003). No significant relationship between the expression of WLS and tumor location, size, and differentiation was found. The survival analyses showed WLS was an independent prognostic marker and that patients whose carcinoma exhibited high expression of WLS had a poorer outcome (p = 0.033). Our results indicate that WLS may play a role in invasion and metastasis of colorectal carcinoma. The WLS protein expression level may be used as a potential prognostic marker in colorectal carcinoma. Furthermore, the WLS gene may provide a novel target for therapy of colorectal carcinoma.     

Downregulated P1 promoter-driven hepatocyte nuclear factor-4alpha expression in human colorectal carcinoma is a new prognostic factor against liver metastasis

Liver metastases are the most critical prognostic factors for patients with colorectal carcinomas (CRC). It has been reported that the dysregulation of hepatocyte nuclear factor-4alpha (HNF4alpha) expression is linked to the development of CRC, gastric cancer and hepatocellular carcinoma. The purpose of the present paper was to examine the P1 and P2 promoter-driven HNF4alpha (P1 and P2) expression in surgically resected CRC. Immunohistochemically, P1, P2, MUC1 and CD10 expression were evaluated in 63 cases of primary CRC. Positive staining with P1, P2, MUC1 and CD10 antibodies were observed in 37 (59%), 63 (100%), 42 (67%) and 27 (43%) cases, respectively. Loss or decreased P1 expression was observed with respect to the depth of the tumor invasion. The frequency of P1-positive expression in Dukes' C and D tumors was significantly lower than that in Dukes' A and B tumors. There was a relationship between the loss of P1 expression and metachronous liver metastases, and the survival rate of the P1-negative patients without liver metastasis at the time of the primary CRC resection tended to be worse than that of the P1-positive patients. These findings suggest that downregulation of P1 expression is involved in tumor metastasis and a worse prognosis.