胃癌PI3K和Akt及Survivin表达与临床病理特征及预后的相关性研究

Relationship between the expressions of PI3K,Akt,Survivin and clinicopathologic parameters and prognosis in patients with gastric cancer

目的探讨胃癌组织中PI3K、Akt和Survivin表达与临床病理特征及预后的关系,为胃癌的诊断和预后评估提供理论依据。方法采用免疫组化En Vision法检测75例胃癌组织中PI3K、Akt和Survivin表达,分析其表达与临床病理特征的关系;采用Spearman相关检验分析三者表达之间的关系;采用Kaplan-Meier法进行生存分析;采用Cox多因素回归模型分析影响胃癌预后的独立因素。结果胃癌组织中PI3K、Akt和Survivin阳性表达率分别为73.3%(55/75)、38.7%(29/75)和61.3%(46/75)。PI3K、Akt和Survivin表达与分化程度、TNM分期、淋巴结转移均有关(P<0.05),而与性别、年龄、肿块大小、治疗前CEA水平无关(P>0.05);PI3K与Akt、Survivin表达呈正相关(r=0.293,P<0.05;r=0.450,P<0.05)。Kaplan-Meier生存分析显示,PI3K、Akt、Survivin、分化程度、TNM分期及淋巴结转移与预后有关(P<0.05);Cox多因素回归分析显示,Survivin表达、淋巴结转移为影响胃癌预后的独立因素(P<0.05)。结论 PI3K、Akt和Survivin表达与胃癌侵袭、转移密切相关,PI3K与Akt、Survivin之间可能存在协同作用,共同促进胃癌的恶性进展,Survivin是影响胃癌预后独立的因素之一。

Objective To investigate the relationship between the expression of PI3K,Akt and Survivin and clinicopathological features and prognosis in gastric cancer,and to provide theoretical basis for the diagnosis and prognosis evaluation of gastric cancer.Methods The expression levels of PI3K,Akt and Survivin were detected in 75 gastric cancer tissues using En Vision immunohistochemical method. The relationship between the expression and the clinicopathological features was analyzed. In addition,Spearman correlation test was used to analyze the relationship between the expressions of PI3K,Akt and Survivin. Survival analysis was performed by Kaplan-Meier method,and Cox multivariate regression analysis was used to identify the independent prognostic factors of gastric cancer. Results In gastric cancer tissues,the positive rates of PI3K,Akt and Survivin were 73. 3 %（55/75）,38. 7%（29/75） and61. 3 %（46/75） respectively. The expression of PI3K,Akt and Survivin was related to the degree of differentiation,TNM staging and lymph node metastasis（ P〈0. 05）,but not with sex,age,size of the mass,and the level of CEA before treatment（ P〉0. 05）. The expression of PI3K was positively correlated with Akt and Survivin expression（ r = 0. 293,P〈0. 05; r = 0. 450,P〈0. 05）. PI3K,Akt,Survivin,differentiation,TNM staging and lymph node metastasis were correlated with prognosis in gastric cancer. Cox regression analysis showed that Survivin,lymph node metastasis were independent prognostic factors of gastric cancer（ P〈0. 05）. Conclusion The expression of PI3K,Akt and Survivin is closely related to the invasion and metastasis of gastric cancer. There may be a synergistic effect between PI3K and Akt,PI3K and Survivin,which jointly promote the malignant progression of gastric cancer. Survivin is one of the independent factors that affect the prognosis of gastric cancer.