World J Oncol

World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access

Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc

Journal website https://www.wjon.org

Original Article

Volume 14, Number 1, February 2023, pages 84-93

The Impact of DTYMK as a Prognostic Marker in Colorectal Cancer

Figures

Figure 1. High expression level of DTYMK in colorectal cancer (COAD). (a) DTYMK gene expression was upregulated in several types of human malignancies especially in COAD. (b) Using GEO dataset, analysis of DTYMK expression in three pairs of tumors vs. normal of CRC patients. (c, d) Using UALCAN website, analysis of DTYMK at mRNA and protein levels. (e, f) Using Oncomine database, analysis of DTYMK in several COAD study cohorts. *P value < 0.05 was considered to be significant [16]. CRC: colorectal cancer; DTYMK: deoxythymidylate kinase; COAD: colorectal adenocarcinoma.

Figure 2. DTYMK protein expression by IHC. (a) These images show the DTYMK IHC grading system (original magnification × 20). Negative (0), weak (1+), moderate (2+), and strong (3+) grading systems were constructed based on DTYMK staining intensity. (b) In four cases, illustrative photographs depict examples of high DTYMK H-score and low DTYMK low H-score (original magnification was × 10 and × 20). DTYMK: deoxythymidylate kinase; IHC: immunohistochemistry.

Figure 3. Correlation between DTYMK and MMR proteins. (a-d) Analysis of the association between DTYMK IHC and PMS2, MLH1, MSH6 and MSH2 IHC results, respectively. P value < 0.05 was considered to be significant. (e) The overall survival (OS) and progression-free interval (PFI) analysis for high DTYMK vs. low DTYMK mRNA levels. Log rank P value < 0.05 was considered to be significant. DTYMK: deoxythymidylate kinase; IHC: immunohistochemistry; MMR: mismatch repair.

Tables

**Table 1.** Clinical and Pathological Features for the 227 Colorectal Cancer (COAD) Patients
Clinicopathological characteristics	Variables	n (%)
COAD: colorectal adenocarcinoma; NA: not given.
Age	Less than 59	105 (46)
	More than 60	122 (54)
Sex	Male	136 (60)
	Female	91 (40)
Tumor differentiation	Low	44 (19)
	Moderate	139 (61)
	High	33 (15)
	NA	11 (5)
Tumor stage	T1	1 (0)
	T2	37 (16)
	T3	119 (53)
	T4	65 (29)
	NA	5 (2)
	N0	155 (68)
	N1	47 (21)
	N2	20 (9)
	NA	5 (2)
Stage	Stage I	36 (16)
	Stage II	119 (53)
	Stage III	64 (28)
	Stage IV	3 (1)
	NA	5 (2)
Site of primary tumor	Colon	102 (45)
	Intestine	1 (0)
	Left hemicolon	8 (4)
	Right hemicolon	70 (31)
	Sigmoidal colon	37 (16)
	Transverse colon	4 (2)
	Ascending colon	5 (2)

**Table 2.** The Findings of the Scores Obtained for DTYMK Protein Expression
Score	Patients (227) (n, %)
DTYMK: deoxythymidylate kinase.
0	3 (1.3)
1	1 (0.4)
2	5 (2.2)
3	6 (2.6)
4	15 (6.6)
6	16 (7.2)
8	30 (13.2)
9	29 (12.8)
12	122 (53.7)

**Table 3.** Comparison of Patients With Low Versus High DTYMK H-Score in Their Colorectal Adenocarcinomas Pathological Variables (n = 227)
Clinicopathological characteristics	Variables	DTYMK low H-score; n	DTYMK high H-score; n	P-value
Clinicopathological parameters were assessed using Pearson Chi-square analysis. *P < 0.05. DTYMK: deoxythymidylate kinase.
Age	Less than 59	60	54	0.036*
	More than 60	45	68
Sex	Male	64	41	0.436
	Female	72	50
Differentiation grade	Well	15	79	0.106
	Poor/moderate	29	23
Tumor size	T1	0	1	0.782
	T2	15	22
	T3	54	64
	T4	31	34
Stage	Stage I	14	22	0.038*
	Stage II	54	65
	Stage III	29	35
	Stage IV	3	3
Node	N0	58	87	0.842
	N1	22	25
	N2	10	10
Tumor site	Colon	57	45	0.032*
	Right colon	29	41
	Left colon	12	25
	Sigmoidal colon	4	4