D2-40、Ki-67、P53表达水平与结直肠癌淋巴结转移及术后辅助化疗后早期复发/转移的相关性研究OA

Objective To investigate the correlations of expression levels of D2-40,Ki-67 and P53 with lymph node metastasis and early recurrence/metastasis after postoperative adjuvant chemotherapy in colorectal cancer(CRC).Methods Clinical data of 205 patients with CRC treated in our hospital from March 2021 to March 2025 were retrospectively analyzed.According to pathological findings,total 70 CRC patients with lymph node metastasis were assigned to the metastasis group,and 135 patients without lymph node metastasis to the non-metastasis group.Immunohistochemistry was applied to detect the expression levels of D2-40,Ki-67 and P53 in postoperative pathological tissues.Clinical data were compared between the two groups,and risk factors for CRC were analyzed.Patients were stratified by expression level of Ki-67,and the lymph node metas-tasis rate of each subgroup was calculated.Receiver operating characteristic(ROC)curves were plotted to determine the optimal cut-off values and area under the curve(AUC)of Ki-67 and D2-40,and the predictive values of single and combined detection of the above biomarkers for lymph node metastasis of CRC were ana-lyzed.All CRC patients received at least 4 cycles of adjuvant chemotherapy with FOLFOX or XELOX regi-mens.Electronic colonoscopy and thoracoabdominal CT reexamination were performed half a year after sur-gery.Based on tumor recurrence status,75 patients without abnormal imaging findings were included in the non-recurrence group,and 13 patients with recurrence/metastasis in the recurrence group.Clinical characteris-tics and differential expression of D2-40,Ki-67 and P53 were compared between the two groups.Results Lymph node metastasis of CRC was correlated with tumor differentiation,vascular tumor thrombus,depth of tumor invasion and D2-40 expression(P<0.01).Ki-67 expression was significantly higher in the lymph node metastasis group than in the non-metastasis group(P<0.05).The lymph node metastasis rate of CRC rose with the increase of Ki-67 expression.The AUC of Ki-67 for predicting lymph node metastasis was 0.599(95%CI:0.518-0.681,P=0.02).The optimal cut-off value of Ki-67 was 75.0%,with a sensitivity of 39.1%and specificity of 77.0%for predicting lymph node metastasis.Half-year postoperative follow-up revealed that patients with low Ki-67 expression were more prone to early recurrence/metastasis after CRC sur-gery(P<0.05).Conclusion Postoperative Ki-67 detection can predict lymph node metastasis in CRC.Lymph node metastasis is highly likely when the expression ratio of Ki-67 exceeds 75%.Ki-67 may also serve as a potential biomarker for monitoring early clinical recurrence/metastasis after CRC treatment.