胃肠间质瘤组织中第10号染色体缺失的磷酸酶张力蛋白同源物基因蛋白和磷酸化蛋白激酶B蛋白的表达及其对患者预后的影响

Expression of phosphatase and tension homology deleted on chromosome ten and phospho-protein kinase B protein in gastrointestinal stromal tumor and their effects on the prognosis of patients

目的探讨胃肠间质瘤组织中第10号染色体缺失的磷酸酶张力蛋白同源物基因(PTEN)、磷酸化蛋白激酶B(p-PKB,又称p-Akt)表达水平以及其对患者预后的影响。方法选取行手术治疗的胃肠间质瘤患者116例为研究组,选取116例相对应的瘤旁正常胃肠道组织作为对照组。采用免疫组织化学法测定2组PTEN、p-Akt的表达水平;分析PTEN、p-Akt表达水平与胃肠间质瘤临床病理特征的关系;分析PTEN、p-Akt表达水平与胃肠间质瘤患者无复发生存状况的关系;探讨影响胃肠间质瘤患者预后的因素。结果PTEN在研究组中的阳性表达率低于对照组,而p-Akt在对照组中的阳性表达率高于对照组,差异有统计学意义(P<0.05)。PTEN的低表达、p-Akt的高表达与胃肠间质瘤组织的核分裂象、危险度分级、浸润深度有关(P<0.05)。PTEN阳性胃肠间质瘤患者平均无复发生存时间长于PTEN阴性胃肠间质瘤患者,差异有统计学意义(P<0.05);p-Akt阴性胃肠间质瘤患者平均无复发生存时间长于p-Akt阳性胃肠间质瘤患者,差异有统计学意义(P<0.05)。病理性核分裂象、浸润深度、PTEN阴性表达、p-Akt阳性表达是影响胃肠间质瘤患者预后的影响因素(P<0.05)。结论胃肠间质瘤组织中PTEN、p-Akt的表达情况与患者预后关系密切,可为评估患者预后提供参考。

Objective To investigate the expression levels of phosphatase and tensin homology deleted on chromosome ten(PTEN)and phospho-protein kinase B(p-PKB,also called p-Akt)in gastrointestinal stromal tumor and and their effects on prognosis of patients.Methods A total of 116 patients with gastrointestinal stromal tumor undergoing surgical treatment were selected as study group,and the corresponding normal adjacent gastrointestinal tissues were selected as control group.The expression levels of PTEN and p-Akt in the two groups were determined by immunohistochemistry;the relationships between the expression levels of PTEN,p-Akt and the clinicopathological features of gastrointestinal stromal tumor were analyzed;the relationships between the expression levels of PTEN,p-Akt and relapse-free survival of patients with gastrointestinal stromal tumor were analyzed;the prognostic factors of gastrointestinal stromal tumor were investigated.Results The positive expression rate of PTEN in the study group was significantly lower,while the positive expression rate of p-Akt in the control group was significantly higher than that in the control group(P<0.05).The low expression of PTEN and high expression of p-Akt were related to the mitosis,risk grade and invasion depth of gastrointestinal stromal tumor(P<0.05).The mean recurrence-free survival time of patients with PTEN positive gastrointestinal stromal tumor was significantly longer than that in patients with PTEN negative gastrointestinal stromal tumor(P<0.05);the mean recurrence-free survival time of patients with p-Akt negative gastrointestinal stromal tumor was significantly longer than that of patients with p-Akt positive gastrointestinal stromal tumor(P<0.05).Pathological mitosis,depth of infiltration,negative expression of PTEN and positive expression of p-Akt were the influencing factors for prognosis in patients with gastrointestinal stromal tumor(P<0.05).Conclusion The expression of PTEN and p-Akt are closely related to the prognosis of gastrointestinal stromal tumor,which can provide the reference for predicting the prognosis.