直肠癌组织Akt-mTOR蛋白表达与临床病理因素相关性分析  

Expression of Akt-mTOR signal pathway in rectal cancer tissues and its prognostic value

作　　者：张毅[1,2] 张甘露[3] 王俊红[1,4] 赵长林[1,4] 宫爱民[1,2] 胡芳娟[1,4] 袁俊波[1,4] 

机构地区：[1]大连大学附属新华医院 [2]大连大学肿瘤研究所肛肠科,辽宁大连116021 [3]浙江医院肿瘤科,浙江杭州310007 [4]大连大学肿瘤研究所肿瘤科,辽宁大连116021

出　　处：《中华肿瘤防治杂志》2013年第4期296-300,共5页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:探讨直肠癌组织Akt-mTOR蛋白表达与临床病理特征和预后的相关性。方法:应用免疫组织化学技术检测Akt和mTOR蛋白在60例直肠癌组织、30例直肠腺瘤组织及10例癌旁正常黏膜组织中的表达,并对60例患者进行随访。结果:Akt蛋白在直肠癌组织、直肠腺瘤及正常直肠黏膜组织中的阳性表达率分别为60.0%(36/60)、33.3%(10/30)和10.0%(1/10),其在直肠癌组织与直肠腺瘤组织、正常直肠黏膜组织中的表达差异均有统计学意义(χ2值分别为5.692和8.600,P值分别为0.017和0.003),直肠腺瘤组织与正常直肠黏膜组织中的表达差异无统计学意义,χ2=2.048,P=0.152;mTOR蛋白在直肠癌组织、直肠腺瘤及正常直肠黏膜组织中的阳性表达率分别为61.7%(37/60)、36.7%(11/30)和10.0%(1/10);其在直肠癌组织与直肠腺瘤组织、正常直肠黏膜组织中的表达差异均有统计学意义(χ2值分别为5.022和9.220,P值分别为0.017和0.002),直肠腺瘤组织与正常直肠黏膜组织中的表达差异无统计学意义,χ2=2.540,P=0.111。两者在直肠癌组织中过表达并成正相关,r=0.583,P<0.05。Akt蛋白表达水平与患者的术前CEA水平、TNM分期、淋巴结转移和远处转移有关,P<0.05;与患者的年龄、性别、肿瘤部位、形态和分化程度无关,P>0.05;mTOR蛋白表达水平与患者的术前CEA水平、分化程度、TNM分期、淋巴结转移和远处转移有关,P值均<0.01;与患者的年龄、性别、肿瘤部位和形态无关,P>0.05。Cox回归模型分析显示,远处转移是直肠癌的独立预后危险的因素。结论:Akt-mTOR信号通路在直肠癌组织中表达水平均与CEA水平、TNM分期、淋巴结转移和远处转移有关,但其与预后的关系仍需进一步研究。OBJECTIVE： To explore the expression of Akt-mTOR signal pathway in rectal cancer and to analyze the relationship between the expression and pathological and prognostic facto. METHODS： Akt and Mtor were stained immu- nohistochemically in rectal cancer,rectal adenoma and normal rectal mucosal tissue,and 60 patiens were followed up. RE- SULTS： The positive expression racts of Akt in carcinoma tissue, rectal adenoma and normal rectal mucosal tissue were 60.0 % （36/60）, 33.3 % （10/30）, 10.0 % （1/10） respectively, and there was statistical significant between rectal cancer tis- sues and rectal adenoma tissues （X2 = 5. 692, P = 0.017）, and had statistical significant between rectal adenoma tissues and normal rectal mucosa tissues（x2 = 8. 600, P= 0. 003）, but no statistical significant between rectal adenoma tissues and nor- mal rectal mucosa tissues （X2 = 2. 048, P = 0. 152） while the positive expression rates of roTOR were 61.7 % （37/60）, 36.7 % （11/30）, 10.0 % （1/10）. and there had statistical significant between rectal cancer tissues and rectal adenoma tis- sues（xz= 5. 022,P=0. 017）,and had statistical significant between rectal adenoma tissues and normal rectal mucosa tis- sues（x2 = 0. 220, P=0. 002）, but no statistical significant between rectal adenoma tissues and normal rectal mucosa tissues （X2= 2. 540,P= 0. 111）. The expression of Akt and mTOR in rectal carcinoma were positively relative （r= 0. 583, P〈 0.05）. The positive expression of Akt had correlations with CEA, TNM stage, lymph node metastasis, metastasisfrom1 blood vessels （ P〈0. 01 ）, but had no correlation with gender, age, tumor morphology and location, differentiation （P〉0.05）. The positive expression of mTOR had correlations with CEA, TNM stage, differentiation, lymph node metas tasis,metastasis from blood vessels （P〈0.05）, but had no correlation with gender, age, tumor morphology ;Jnd location （P〉0.05）. Multivariate analysis identified that metastasis is important

关 键 词：直肠肿瘤 蛋白激酶B 雷帕霉素靶蛋白 预后 

分 类 号：R735.37[医药卫生—肿瘤]