PTEN、Akt和pAkt蛋白在肝细胞癌组织中的表达及其与预后的关系

Clinical significance of expression of PTEN,Akt and pAkt in hepatocellular carcinoma

目的:探讨人肝细胞癌组织中PTEN、Akt和pAkt蛋白的表达及其预后价值.方法:应用免疫组织化学方法检测78例肝细胞癌组织及21例正常肝组织中PTEN、Akt和pAkt蛋白的表达,分析其与肝细胞癌临床病理特征及预后的关系.结果:在肝细胞癌组织中,PTEN蛋白的表达率显著低于正常肝组织(42.3%vs90.5%,P<0.05),Akt及pAkt蛋白的表达率显著高于正常肝组织(66.7%vs33.3%;43.6%vs9.5%,均P<0.05).PTEN蛋白的表达水平与肿瘤直径、门静脉癌栓、侵及周围脏器或淋巴结转移及TNM分期有关(均P<0.05);Akt及pAkt蛋白的表达水平与肿瘤直径、侵及周围脏器或淋巴结转移及TNM分期有关(均P<0.05).PTEN与Akt蛋白表达呈负相关(r=-0.385,P=0.000),与pAkt蛋白表达呈负相关(r=-0.334,P=0.003).PTEN蛋白高表达患者术后生存率明显高于低表达患者(P=0.000),Akt、pAkt蛋白高表达患者术后生存率明显低于低表达患者(P=0.000).COX模型多因素分析结果显示,TNM分期及pAkt蛋白的表达是影响肝细胞癌预后的独立因素.结论:肝细胞癌组织中PTEN、Akt及pAkt的表达失调与肝细胞癌的恶性生物学行为密切相关,pAkt可以作为评价患者预后的指标.

AIM：To explore the expression of phosphatase and tensin homology deleted on chromosome ten（PTEN）,Akt and pAkt proteins in hepatocellular carcinoma（HCC） and to elucidate their clinical significance.METHODS：Immunohistochemical analysis was performed to detect the expression of PTEN,Akt and pAkt proteins in 78 specimens of hepatocellular carcinoma and 21 specimens of normal liver tissues.The relationship of their expression with clinicopathological and prognostic parameters was analyzed.RESULTS：The rate of PTEN overexpression was significantly lower in HCC than in normal liver tissue（42.3% vs 90.5%,P 0.05）,while the rates of Akt and pAkt overexpression were significantly higher in HCC than in normal liver tissue（66.7% vs 33.3%;43.6% vs 9.5%,both P 0.05）.PTEN expression was correlated with tumor size,cancer embolus of the portal vein,tumor invasion,lymph node metastasis and TNM stage.Akt and pAkt expression was correlated with tumor size,invasion,lymph node metastasis and TNM stage.PTEN expression was negatively correlated with Akt（r =-0.385,P = 0.000） and pAkt（r =-0.334,P = 0.003） expression in HCC.Patients with low PTEN expression or high Akt and pAkt expression had a significantly worse survival time than those with high PTEN expression or low Akt and pAkt expression（P = 0.000）.A multivariate analysis based on the COX regression model demonstrated that TNM stage and pAkt expression were independent prognostic factors for HCC.CONCLUSION：The expression of PTEN,Akt and pAkt proteins is closely related to the malignant biological behavior of HCC.pAkt can be used as a key factor for predicting prognosis in HCC patients.