PI3K/AKT/mTOR通路在结直肠癌中的表达及靶向治疗研究

The expression of PI3K/AKT/mTOR pathway in colorectal cancer and its targeted therapy

目的研究磷脂酰肌醇3-激酶/蛋白激酶B/哺乳动物雷帕霉素靶蛋白(PI3K/AKT/mTOR)通路在结直肠癌中的表达及靶向治疗。方法将我院2017年4月至2018年4月收治的66例结直肠癌患者纳入观察组,另外选取同期于我院体检健康的志愿者66名纳入对照组。观察组患者入院后均在治疗前通过电子肠镜获取癌组织标本及癌旁组织标本,对照组志愿者入院后通过电子肠镜获取正常结直肠黏膜组织标本,对比癌组织、癌旁组织、正常肠黏膜组织中AKT、mTOR阳性检出率,对比两组AKT、mTOR蛋白水平间的差异,分析不同临床特征(性别、年龄、肿瘤大小、淋巴结转移情况、分化程度、TNM分期)的结直肠癌患者AKT、mTOR阳性表达情况。结果观察组AKT、mTOR蛋白水平显著高于对照组,差异有统计学意义(P<0.05)。不同组织中AKT、mTOR阳性检出率对比,癌组织>癌旁组织>正常肠黏膜组织,差异有统计学意义(P<0.05)。不同性别、年龄、肿瘤大小患者间AKT、mTOR阳性检出率对比差异无统计学意义(P>0.05);淋巴结转移、低分化、TNM分期Ⅳ~Ⅲ期患者的AKT及mTOR阳性检出率显著高于无淋巴结转移、中-高分化、TNM分期Ⅰ~Ⅱ期患者,差异有统计学意义(P>0.05)。结论结直肠癌患者AKT、mTOR蛋白水平呈现出高表达,癌组织内AKT、mTOR阳性检出率高,与淋巴结转移、分化程度、TNM分期关系密切。

Objective To study the expression and targeted therapy of phospholipinositol 3-kinase/protein kinase B/mammalian target of rapamycin(PI3 K/AKT/m TOR)pathway in colorectal cancer.Methods 66 colorectal cancer patients admitted to our hospital from April 2017 to April 2018 were selected as the study subjects and set as the observation group.In addition,66 healthy volunteers from our hospital were selected as the study subjects and set as the control group.Observation group of patients admitted to hospital after before treatment through electronic colonoscopy for tissue adjacent to carcinoma tissue specimens and the specimens,the control group of volunteers through electronic colonoscopy after admission to obtain the normal colorectal mucosa tissue samples,compare the tissue adjacent to carcinoma tissue,in normal intestinal mucosa tissues,AKT,m TOR positive detection rate,comparing the differences between two groups of AKT,m TOR protein level,in addition to observe different clinical characteristics(gender,age,tumor size,lymph node metastasis,extent of differentiation,TNM stage)AKT,m TOR positive expression in patients with colorectal cancer.Results The protein levels of Akt and m TOR in the observation group were significantly higher than those in the control group(P<0.05).The positive rates of Akt and m TOR in different tissues were compared.The difference was statistically significant(P<0.05).There was no significant difference in Akt and m TOR positive rates among patients with different gender,age and tumor size(P>0.05);The positive rates of Akt and m TOR in patients with lymph node metastasis,low differentiation and TNM stage IV-III were significantly higher than those in patients without lymph node metastasis,medium high differentiation and TNM stage I-II(P>0.05).Conclusion Colorectal cancer patients showed high expression of AKT and m TOR protein,and the positive detection rate of AKT and m TOR in the cancer tissues was high,which was closely related to lymph node metastasis,differentiation degree and TNM stage,and worthy of clinicians’attention.