Absence of AMPK expression is an independent risk factor for stage II/III colorectal cancer recurrence

This study aimed to investigate the relationship between AMP-activated protein kinase (AMPK) expression and cancer recurrence in patients with stage II or III colorectal cancer (CRC). This retrospective analysis included 286 patients with stage II or III CRC who underwent curative resection between 2005 and 2012. Immunohistochemical staining for AMPK was performed on tissue microarrays. Statistical analyses, including Kaplan–Meier survival analysis and Cox proportional hazards regression, were performed to assess recurrence-free and overall survival. AMPK was expressed in tumor tissues from 215 patients (75.2%) and not expressed in those from 71 patients (24.8%). Univariate analysis revealed that recurrence was significantly associated with the absence of AMPK expression ( p = .002), tumor deposits ( p = .001), lymphatic invasion ( p < .001), vascular invasion ( p = .002), and N category ( p = .001). The logistic regression model identified the absence of AMPK expression as the only independent risk factor associated with recurrence (95% confidence interval: 1.176–4.255; p = .014). Kaplan–Meier analysis showed that patients without AMPK expression had significantly shorter recurrence-free ( p < .001) and overall ( p = .011) survival than those with AMPK expression. The absence of AMPK expression is associated with recurrence in patients with stage II or III CRC. AMPK may, therefore, be a useful prognostic marker in CRC and warrants further investigation.