Open Access Highly Accessed Open Badges Research article

DEK over expression as an independent biomarker for poor prognosis in colorectal cancer

Lijuan Lin12, Junjie Piao1, Wenbin Gao3, Yingshi Piao4, Guang Jin4, Yue Ma1, Jinzi Li15* and Zhenhua Lin14*

Author Affiliations

1 Department of Pathology, Yanbian University College of Medicine, Yanji 133002, China

2 Department of Medical Imaging, Eastern Liaoning University College of Medicine, Dandong 118002, China

3 Department of Oncology, Affiliated Zhongshan Hospital of Dalian University, Dalian 116000, China

4 Cancer Research Center, Yanbian University, Yanji 133002, China

5 Department of Internal Medicine, Yanbian University Affiliated Hospital, Yanji 133000, China

For all author emails, please log on.

BMC Cancer 2013, 13:366  doi:10.1186/1471-2407-13-366

Published: 31 July 2013



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. This study explores the roles of DEK in tumor progression and as a prognostic determinant of colorectal cancer.


Colorectal 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.


DEK 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.


DEK plays an important role in the progression of colorectal cancers and it is an independent poor prognostic factor of colorectal cancers.

Colorectal cancer; DEK; Immunohistochemistry; Survival analysis