Abstract
BackgroundThe DEK protein is related to chromatin reconstruction and gene transcription, and plays an important role in cell apoptosis. High expression levels of the human DEK gene have been correlated with numerous human malignancies. This study explores the roles of DEK in tumor progression and as a prognostic determinant of colorectal cancer.MethodsColorectal cancer specimens from 109 patients with strict follow-up, and colorectal adenomas from 52 patients were selected for analysis of DEK protein by immunohistochemistry. The correlations between DEK over expression and the clinicopathological features of colorectal cancers were evaluated by Chi-square test and Fisher’s exact tests. The survival rates were calculated by the Kaplan-Meier method, and the relationship between prognostic factors and patient survival was also analyzed by the Cox proportional hazard models.ResultsDEK protein showed a nuclear immunohistochemical staining pattern in colorectal cancers. The strongly positive rate of DEK protein was 48.62% (53/109) in colorectal cancers, which was significantly higher than that in either adjacent normal colon mucosa (9.17%, 10/109) or colorectal adenomas (13.46%, 7/52). DEK over expression in colorectal cancers was positively correlated with tumor size, grade, lymph node metastasis, serosal invasion, late stage, and disease-free survival- and 5-year survival rates. Further analysis showed that patients with late stage colorectal cancer and high DEK expression had worse survival rates than those with low DEK expression. Moreover, multivariate analysis showed high DEK expression, serosal invasion, and late stage are significant independent risk factors for mortality in colorectal cancer.ConclusionsDEK plays an important role in the progression of colorectal cancers and it is an independent poor prognostic factor of colorectal cancers.
Highlights
The DEK protein is related to chromatin reconstruction and gene transcription, and plays an important role in cell apoptosis
DEK protein is over expressed in colorectal cancer DEK protein expression showed a nuclear immunohistochemical staining pattern in colorectal cancers (Figure 1)
We found that the strongly positive rate of DEK protein was significantly higher in colorectal cancers with lymph node metastasis (63.27%, 31/49) than in cases without metastasis (36.67%, 22/60) (P=0.006)
Summary
The DEK protein is related to chromatin reconstruction and gene transcription, and plays an important role in cell apoptosis. High expression levels of the human DEK gene have been correlated with numerous human malignancies such as glioblastoma, melanoma, breast cancer, ovarian cancer and hepatocellular carcinoma [1,4,6,7]. Our previous study [12] showed that DEK protein expression was closely related with the proliferation of both ovarian and breast cancers, and that its over expression was significantly correlated with the increased Ki-67 proliferation index in uterine cervical cancers. These studies suggest that DEK activities may be essential for cancer progression. DEK depletion has been suggested as a novel therapeutic method for cancer-targeted therapy
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