结直肠癌组织中PTEN、PI3K的表达与其病理特点及预后的相关性研究  

Study on the expressions of PTEN,PI3K and the correlation with pathological characteristics and prognosis in colorectal carcinoma

作　　者：龚青[1,2] 王茜[1] 陈浩宇[1] 郑唯强[3] 陈洁[1] 

机构地区：[1]第二军医大学附属长海医院消化内科,上海200433 [2]徐汇区中心医院老年病科 [3]第二军医大学附属长海医院病理科

出　　处：《胃肠病学和肝病学杂志》2016年第5期547-553,共7页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的研究结直肠癌组织中PTEN/PI3K/Akt信号通路上PTEN、PI3K的表达与结直肠癌病理特点及预后的关系,探讨PTEN、PI3K在结直肠癌发生、发展及预后中的作用。方法选取2013年1月-2014年12月第二军医大学附属长海医院术后病理证实的结直肠癌石蜡标本且临床资料齐全者67例作为研究组。另选择30例距肿瘤边缘5 cm以外的正常结肠黏膜组织作为对照组。应用免疫组织化学染色方法检测结直肠癌及癌旁组织中PTEN、PI3K和CD34的表达水平,并对其在结直肠癌组织中的表达与年龄、临床分期、肿瘤直径、病理类型及淋巴结转移等病理特点的关系进行分析。结果结直肠癌组织中PTEN、PI3K蛋白的阳性表达率分别为50.7%、67.2%,癌旁正常组织中的阳性表达率为93.3%、13.3%,两组比较,差异均有统计学意义（χ^2=16.30、24.01,P〈0.05）。结直肠癌组织中的MVD值明显高于癌旁组织,差异有统计学意义（t=7.52,P〈0.05）。结直肠癌组织中PTEN蛋白表达与肿瘤直径、浸润深度、Dukes分期、淋巴结转移具有相关性（P〈0.05）,而与性别、年龄、肿瘤部位、分化程度无明显相关（P〉0.05）;PI3K蛋白表达与Dukes分期和淋巴结转移具有相关性（P〈0.05）,而与性别、年龄、肿瘤部位、分化程度、浸润深度、肿瘤直径无相关性（P〉0.05）。结直肠癌组织PTEN与PI3K的表达呈显著负相关（r=-0.617,P〈0.05）,PTEN与MVD值呈显著负相关（r=-0.594,P〈0.05）,而PI3K与MVD值呈显著正相关（r=0.425,P〈0.05）。Kaplan-Meier生存分析法显示结肠癌患者的中位TTP为18.2个月（95%CI：15.9~20.4）,其中PTEN阳性者中位TTP为19.7个月（95%CI：15.5~23.8）,PTEN阴性者中位TTP为16.5个月（95%CI：12.0~20.9）,PTEN阳性者的中位TTP显著高于阴性者,差异有统计学意义（χ^2=3.57,P〈0.05）。PI3K阳性者中位TTP为16.8个月（95%CI：13.0~20.0）,PI3K阴性者中位TTP为18.2个月（95%CI：16.8~21Objective To study the expressions of PTEN and PI3K of PTEN/PI3K/Akt signal transduction pathway in the colorectal carcinoma tissue, and to analyze the correlation with the clinic pathological factors and prognosis of colorectal carcinoma, and to discuss the role of expressions of PTEN and PI3K in the occurrence of colorectal carcino- ma. Methods Sixty-seven patients with complete clinical data who were colorectal carcinoma pathologically confirmed after operation from Jan. 2013 to Dec. 2014 in Changhai Hospital were selected. Thirty cases of normal colonic mucosa tissues at 5 cm outside the tumor edge were also selected as control group. The expressions of PTEN, PI3K and CD34 in the colorectal carcinoma tissue and para-carcinoma tissue were detected by immunohistochemical staining, the correlation between three indicators above and pathological features such as age, clinical stage, tumor diameter, pathological types and lymph node metastasis were analyzed. Results The expressions of PTEN and PI3K in colorectal carcinoma tissue were 50.7%, 67.2%, and 93.3%, 13.3% in para-carcinoma tissue, there was statistically significant （X2 = 16.30, 24.01 ,P 〈0.05）. The count of MVD in colorectal carcinoma was significantly higher than that in para-carcinoma tissue（ t = 7.52, P 〈 0.05）. The expression of PTEN in colorectal carcinoma was related with tumor diameter, depth of inva- sion, Dukes clinical stages and lymphatic metastasis （P 〈 0.05）, not related with age, sex, tumor site, differentiated degree （P 〉 0.05 ）. The expression of PI3K in colorectal carcinoma was related with Dukes clinical stages and lymphatic metastasis （P 〈 0.05） , not related with age, sex, tumor site, differentiated degree, tumor diameter, depth of invasion （P 〉 0.05 ）. The expression of PTEN was negatively correlated with the expression of PI3K in colorectal carcinoma （r = - 0. 617, P 〈 0.05）. The count of MVD in colorectal carcinoma was negatively correlated with the expression of PTEN （r = - 0. 594, P 〈

关 键 词：结直肠癌 PTEN PI3K 信号通路 病理特点 预后 

分 类 号：R735.3[医药卫生—肿瘤]