磷酸化AKT在卵巢癌中表达的临床意义及其与新癌基因REDD1表达的相关性研究

The clinical significance of the phosphorylated AKT expression and its correlation with new oncogene REDD1 expression in ovarian cancer

目的研究磷酸化蛋白激酶B(p-AKT)在卵巢癌中的表达与卵巢癌患者的临床病理因子以及生存预后之间的关系,并分析p-AKT表达与发育及DNA损伤反应调节基因1(REDD1)表达的相关性。方法收集卵巢癌组织标本95例,交界性肿瘤23例,正常卵巢表面上皮和输卵管组织18例。采用免疫组织化学En Vision两步法检测p-AKT和REDD1的表达,分析p-AKT表达与患者临床病理因子(分期、分级、化疗反应、无瘤生存期和总体生存期等)的关系,并分析p-AKT和REDD1表达的相关性。结果 1卵巢癌组织中p-AKT表达率为55.8%(53/95),均高于卵巢正常上皮组织(16.7%)和卵巢交界性肿瘤组织(13.0%)(P<0.05)。2 p-AKT蛋白的表达与卵巢癌的分化程度低、临床晚分期相关,且在浆液性癌中的高表达率高于其他组织学类型,但与有无腹水形成无显著相关性(P>0.05)。3 p-AKT在化疗无效组患者中的表达高于有效组(P<0.05)。4 pAKT蛋白高表达患者的总体生存期和无瘤生存期低于低表达者(P<0.05)。5卵巢癌中p-AKT的表达和REDD1的表达呈正相关性(C=0.626,P<0.05)。结论 p-AKT是影响卵巢癌患者化疗反应以及预后的一个重要因素;AKT可能被持续性高表达的REDD1激活,从而促进细胞增殖,参与卵巢癌的病理发生。

Objective To investigate clinical significance of the expression of phosphorylated protein kinase B （p-AKT） in ovarian carcinomas,and to evaluate its correlation with the expression of new oncogene REDD1.Methods 18 cases of normal ovarian epithelial tissues and fallopian tube tissues,23 cases of borderline tumor and 95 cases of ovarian carcinoma were collected.The expression of p-AKT and REDD1 were detected with immunohistochemical staining method （EnVision two step methods）.The correlations between the expression of p-AKT and the clinical pathological factors of ovarian cancer patients,including grade,stage,chemotherapy response,disease-free survival time and overall survival time were analyzed.The association of p-AKT and REDD1 expression was also analyzed.Results Expression of p-AKT was found in 55.8％ of the samples,which was significantly higher than those in the normal epithelial tissues （16.7％） （P ＜ 0.05） and borderline tumors （13.0％） （P ＜ 0.05）.Chisquare test suggested that high expression of p-AKT was significantly associated with serous carcinoma （P ＜ 0.05）,low degree of differentiation （P ＜ 0.05）,late clinical stage （P ＜ 0.05）,and chemotherapy resistant （P ＜ 0.05）,but there was no significant correlation with the presence of ascites （P ＞ 0.05）.High percentage of cells expressing p-AKT was associated with a shorter overall survival time （P ＜ 0.05） and disease free survival time （P ＜ 0.05） by Log rank test.Positive correlation was found between p-AKT and REDD1 （C =0.626,P ＜ 0.05）.Conclusion The overexpression of p-AKT had a significant negative impact on the prognostic of ovarian cancer patients.Sustained overexpression of REDD1 leads to AKT activation involved in cancer cells proliferation,leading to the occurrence of ovarian cancer.