PIK3CD表达上调与胃癌临床病理特征及患者预后的相关性

Phosphoinositide-3 catalytic subunit delta in gastric cancer: possible correlations with clinicopathologic characteristics and prognosis

目的:分析磷脂酰肌醇-3激酶催化亚基δ(phosphoinositide-3 kinase,catalytic subunit delta,PIK3CD)表达与胃癌临床病理特征和患者预后的相关性。方法:收集2004年5月至2007年12月在辽宁医学院附属第一医院胃肠外科行肿瘤切除并经病理证实的胃癌患者癌组织标本及相应癌旁组织标本各86例,采用免疫组织化学法检测PIK3CD蛋白在86例胃癌及癌旁组织中的表达;利用χ2检验及Spearman相关性检验探讨PIK3CD表达与胃癌临床病理特征的关系;应用Kaplan-Meier方法分析PIK3CD表达与胃癌患者术后5年生存率及生存时间。结果:相对于癌旁组织,PIK3CD在胃癌组织中的表达明显上调(P=0.006);PIK3CD表达与胃癌浸润深度呈显著相关性(P=0.005),与淋巴结阳性率(P=0.089)和临床分期(P=0.060)有相关趋势但无统计学意义,而与肿瘤大小、组织分化程度、淋巴结和远处转移等无相关性。高表达和低表达PIK3CD的患者术后5年累积生存率分别为18.9%和60.6%,中位生存时间为31.0(95%CI:23.9~38.1)个月和60.6(95%CI:53.8~67.4)个月,Kaplan-Meier分析显示其差异有显著统计学意义(χ2=19.791,P=0.000)。多因素分析显示,PIK3CD可作为一个独立的预后评估因素(P=0.000)。结论:(1)胃癌组织中PIK3CD表达的显著上调提示其具有潜在的促癌作用;(2)PIK3CD表达上调与胃癌的浸润程度和患者生存时间相关,可作为胃癌预后不良评估的一个独立影响因素。

Objective: To analyze the correlation between the expression of phosphoinositide-3 kinase catalytic subunit delta( PIK3CD) and the clinicopathologic characteristics in gastric cancer tissues. Methods: A total of 86 paired tumorous and normal gastric tissue specimens were collected from gastric cancer patients who underwent surgical resection in the Department of Gastrointestinal Surgery,Liaoning Medical University-Affiliated First Hospital in Jinzhou between May 2005 and December 2007. The expression of PIK3 CD at the protein level in these specimens was assessed by immunohistochemistry.The possible correlation between PIK3 CD expression and the patients' clinicopathological characteristics and prognosis was analyzed by χ2and Spearman correlation test. The influence of PIK3 CD on 5-year survival and survival length was analyzed by Kaplan-Meier test. Results: The immunoreactive PIK3 CD protein signal in the tumor proper was significantly stronger in the tumor proper than in the matched adjacent tissue( P = 0. 006). The intensity of PIK3 CD protein signal was positively correlated with infiltration( P = 0. 005),but not with sex,age,differention,clinical stage,lympha nodes metastasis and distance metastasis( P > 0. 05). The 5-year survival rate was 18. 9% and 60. 6% in patients with high and low levels of PIK3 CD respectively( P < 0. 05). The median survival length was 31. 0( 95% CI: 23. 9- 38. 1) months in patients with high levels of PIK3 CD and 60. 6( 95% CI: 53. 8- 67. 4) months in patients with low levels of PIK3CD( χ2= 19. 791,P =0. 000). Elevated PIK3 CD expression was an independent negative prognostic factor of gastric cancer( P = 0. 000). Conclusion: PIK3 CD may function as a pro- oncogeneand an independent prognostic factor in patients with gastric cancer.