目的:结直肠癌(CRC)是全球第三大常见恶性肿瘤。准确的病理诊断和对治疗反应和预后的预测能力对于CRC患者至关重要。本研究旨在分析p21和EGFR在CRC中的表达及其与临床病理特征和预后的关系,以提高诊断和预后评估。
方法:本研究采用免疫组织化学方法对12319例中国CRC患者中p21和EGFR的表达进行了回顾性分析。通过统计学和生存分析探讨这些表达与临床病理特征和生存结果之间的关系。
结果:CRC中p21和EGFR的差异表达与临床病理特征密切相关,并显著影响总生存期(OS)。p21表达与原发肿瘤部位相关,粘液亚型,淋巴管浸润,神经周浸润,环状切除边缘,T级,N级,肿瘤,节点,转移(TNM)分期,和不匹配修复状态。EGFR表达与粘液性亚型有关,肿瘤分化,淋巴管浸润,神经周浸润,肿瘤大小,T级,N级,TNM分期和BRAF基因突变。p21与EGFR表达呈正相关(r=0.11)。高p21表达与有利的OS相关,而高EGFR表达预测OS较差。包含这些生物标志物和临床变量的预后列线图显示了对患者生存率的强大预测能力。
结论:p21和EGFR是潜在的病理诊断指标,风险分层,并预测CRC患者的治疗效果和预后。本研究结果为临床个性化治疗和预后评估提供了有价值的参考。
OBJECTIVE: Colorectal cancer (CRC) is the third most common malignancy worldwide. Accurate pathological diagnosis and predictive abilities for treatment response and prognosis are crucial for patients with CRC. This study aims to analyse the expressions of p21 and EGFR in CRC and their relationships with clinicopathological characteristics and prognosis to enhance diagnostic and prognostic evaluations.
METHODS: This study conducted a retrospective analysis of p21 and EGFR expressions in 12 319 Chinese patients with CRC using immunohistochemistry. The relationships between these expressions and clinicopathological characteristics and survival outcomes were explored through statistical and survival analyses.
RESULTS: Differential expressions of p21 and EGFR in CRC were closely related to clinicopathological characteristics and significantly impacted overall survival (OS). p21 expression was associated with the primary tumour site, mucinous subtype, lymphovascular invasion, perineural invasion, circumferential resection margin, T stage, N stage, tumour, node, metastases (TNM) stage, and mismatch repair status. EGFR expression was related to mucinous subtype, tumour differentiation, lymphovascular invasion, perineural invasion, tumour size, T stage, N stage, TNM stage and BRAF gene mutation. p21 and EGFR expressions were positively correlated (r=0.11). High p21 expression correlated with favourable OS, whereas high EGFR expression predicted poorer OS. A prognostic nomogram incorporating these biomarkers and clinical variables demonstrated robust predictive power for patient survival rates.
CONCLUSIONS: p21 and EGFR serve as potential indicators for pathological diagnosis, risk stratification, and predicting treatment efficacy and prognosis in patients with CRC. The study\'s findings provide valuable references for personalised treatment and prognosis evaluation in clinical practice.