Clinical significance of hepatocyte nuclear factor 4α in rectal cancer and its relationship with prognosis
Wang Juan, Ji Weiping, Yao Houshan, Wang Liangzhe, Hu Zhiqian
2014, 41 (8):
704-708.
doi: 10.3760/cma.j.issn.1673-422X.2014.09.018
ObjectiveTo investigate the clinical significance of hepatocyte nuclear factor 4α (HNF4α) in rectal cancer and its relationship with prognosis. MethodsRealtime PCR was designed to detect the expression of HNF4α on mRNA level and the immunohistochemistry was used to determine the expression of HNF4α on protein level in rectal cancer tissue. The relationship between HNF4α expression and clinical characteristics was also analysed. The KaplanMeier method was used for univariate analysis and a Cox proportional hazards regression model was performed for multivariate analysis. ResultsHNF4α was low expressed both on mRNA (t=6.092, P<0.001) and protein level (χ2=15.230, P<0.001) in rectal cancer tissue. HNF4α expression on protein level was related with the clinical stage (χ2=48.311, P<0.001), depth of invasion (χ2=23.911, P<0.001), histological differentiation (χ2=20.787, P<0.001), lymph node metastasis (χ2=39.064, P<0.001) and distant metastasis (χ2=5.146, P=0.04), while age and gender were not relevant. The cumulative 3year overall survival of patients with low HNF4α expression (43.8%) was much worse than the patients with high HNF4α expression (95.5%), and the difference was statistically significant (P<0.001). Univariate analysis revealed that HNF4α expression (χ2=28.778, P<0.001), differentiation (χ2=26.680, P<0.001), clinical stage (χ2=32.702, P<0.001), depth of invasion (χ2=6.226, P=0.013), lymph node invasion (χ2=15.270, P<0.001) and distant metastasis (χ2=21.817, P<0.001) were statistically significant worse predictors for rectal cancer, whereas age and gender were not relevant. The multivariate Cox proportional hazard analysis revealed that HNF4α low expression (RR=6.084, P=0.028) was independent prognostic markers for 3year overall survival in the patients with rectal cancer. ConclusionHNF4α was closely related to the tumorigenesis and progression of rectal cancer, which is an independent prognostic marker for rectal cancer, and which may be an effective target for the therapy of rectal cancer.
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