Li W, Zhang G, Wang H-L, Wang L
The Pain Department of Cangzhou Central Hospital, Cangzhou City, Hebei Province, China.
Eur Rev Med Pharmacol Sci. 2016 Dec;20(23):4874-4879.
We conducted this study is to investigate the clinical application value of Cyclin E, p27kip1 and Ki67 protein expression in colorectal cancer tissues for diagnosis, treatment, and prognosis of this disease.
The positive expression of Cyclin E, p27kip1 and Ki-67 in tissues of 200 patients with colorectal cancer and 200 patients with benign colorectal tumor or inflammation were detected by immunohistochemistry PowerVision two-step method. RT-PCR was used to detect the expression level of the corresponding mRNA, as well as to analyze the association with TNM staging, pathology type, free progression survival and median survival. The sensitivity, specificity, and accuracy of diagnosis were analyzed by ROC.
The positive expression rate and positive degree of Cyclin E and Ki-67 of observation group were higher than those of the control group, while positive expression rate and positive degree of p27kipl was lower than that of the control group; the differences were statistically significant (p<0.05). The quantitative expression levels of Cyclin E and Ki-67 mRNA of observation group were distinctly higher than those of the control group, while p27kipl was evidently lower than that of the control group; the differences were statistically significant (p<0.05). With the increase of TNM staging, the positive expression of Cyclin E and Ki-67 increased, p27kipl decreased, and the difference was statistically significant (p<0.05). With the decrease of differentiation degree, the positive expression of Cyclin E and Ki-67 increased, p27kipl decreased, and the difference was statistically significant (p<0.05). The free progression survival and median survival of positive expression and negative expression of Cyclin E and Ki-67 were shortened, p27kipl extended, and the difference was statistically significant (p<0.05). The diagnostic sensitivity of Cyclin E mRNA was 89.6%, specificity 84.5%, accuracy 0.823 and the critical value was 0.3562; The diagnostic sensitivity of p27kipl mRNA was 80.5%, specificity 76.5%, accuracy 0.802 and the critical value was 0.3023. The diagnostic sensitivity of Ki-67 mRNA was 86.5%, specificity 82.9%, accuracy 0.814 and the critical value was 0.3243.
We discovered that Cyclin E and Ki67 protein expression of colorectal cancer tissues was upregulated and p27kipl protein expression was downregulated, which were closely related to the TNM and pathological differentiation degree. These values were also closely associated with free progression survival and median survival of prognosis. Therefore, the above indexes can be used as highly sensitive, specific and accurate markers for the diagnosis of colorectal cancer.
本研究旨在探讨细胞周期蛋白E（Cyclin E）、p27kip1和Ki67蛋白表达在结直肠癌组织中对该疾病诊断、治疗及预后的临床应用价值。
采用免疫组织化学PowerVision两步法检测200例结直肠癌患者及200例结直肠良性肿瘤或炎症患者组织中Cyclin E、p27kip1和Ki-67的阳性表达。运用逆转录-聚合酶链反应（RT-PCR）检测相应mRNA的表达水平，并分析其与TNM分期、病理类型、无进展生存期和中位生存期的相关性。通过受试者工作特征曲线（ROC）分析诊断的敏感性、特异性和准确性。
观察组Cyclin E和Ki-67的阳性表达率及阳性强度高于对照组，而p27kipl的阳性表达率及阳性强度低于对照组；差异具有统计学意义（p<0.05）。观察组Cyclin E和Ki-67 mRNA的定量表达水平明显高于对照组，而p27kipl明显低于对照组；差异具有统计学意义（p<0.05）。随着TNM分期的增加，Cyclin E和Ki-67的阳性表达增加，p27kipl降低，差异具有统计学意义（p<0.05）。随着分化程度降低，Cyclin E和Ki-67的阳性表达增加，p27kipl降低，差异具有统计学意义（p<0.05）。Cyclin E和Ki-67阳性表达与阴性表达的无进展生存期和中位生存期缩短，p27kipl延长，差异具有统计学意义（p<0.05）。Cyclin E mRNA的诊断敏感性为89.6%，特异性为84.5%，准确性为0.823，临界值为0.3562；p27kipl mRNA的诊断敏感性为80.5%，特异性为76.5%，准确性为0.802，临界值为0.3023。Ki-67 mRNA的诊断敏感性为86.5%，特异性为82.9%，准确性为0.814，临界值为0.3243。
我们发现结直肠癌组织中Cyclin E和Ki67蛋白表达上调，p27kipl蛋白表达下调，这与TNM分期及病理分化程度密切相关。这些指标还与预后的无进展生存期和中位生存期密切相关。因此，上述指标可作为结直肠癌诊断的高敏感、特异且准确的标志物。
