PI3K/Akt通路蛋白表达对胃癌术后1年内骨转移的预测分析

Predictive analysis of PI3K/Akt pathway protein expression in surgical resection tissues of gastric cancer for bone metastasis within 1 year after operation

目的:探讨胃癌组织磷脂酰肌醇-3激酶(PI3K)/蛋白激酶B(Akt)通路蛋白表达对术后1年内骨转移的预测价值。方法:取112例胃癌手术切除组织,分别采用免疫组化(SP)、蛋白免疫印迹法(WB)检测PI3K/Akt通路蛋白表达。对比胃癌组织、癌旁组织的蛋白阳性表达率和相对表达量;比较术后1年内骨转移发生者和未发生者蛋白阳性表达率和相对表达量;绘制受试者工作特征曲线,分析上述蛋白相对表达量对胃癌手术患者术后1年内骨转移的预测效能。结果:胃癌组织PI3K、p-Akt、p-mTOR蛋白阳性表达率及PI3K蛋白相对表达、p-Akt、p-mTOR水平均高于癌旁组织(P<0.05);术后1年内骨转移发生率为27.68%,发生骨转移患者癌组织PI3K、p-Akt、p-mTOR蛋白阳性表达率及PI3K蛋白相对表达、p-Akt、p-mTOR水平均高于未发生者(P<0.05);PI3K蛋白、p-Akt、p-mTOR预测术后1年内骨转移的最佳截断点分别为1.25、1.11、0.92,三者联合预测术后1年内骨转移发生的灵敏度、特异度、准确度、AUC分别为90.32%、90.12%、82.79%、0.889,其中灵敏度、准确度、AUC均高于单独预测。结论:胃癌组织PI3K、p-Akt、p-mTOR蛋白表达水平均较高,且术后1年内发生骨转移者PI3K、p-Akt、p-mTOR蛋白表达水平更高,三者联合对胃癌切除术后1年内骨转移发生率有良好的预测效能。

Objective:To investigate the predictive value of expression of phosphatidylinositol-3 kinase(PI3K)/protein kinase B(Akt)pathway protein in resected gastric cancer tissues for bone metastasis within 1 year after operation.Methods:Immunohistochemistry(SP)and Western blotting(WB)were used to detect the expression of PI3K/Akt pathway protein in 112 gastric cancer resected tissues.The positive expression rates and relative expression levels of proteins in gastric cancer tissues and adjacent tissues were compared.The positive expression rate and relative expression level of protein in bone metastasis patients and non-bone metastasis patients within 1 year after operation were compared.The working characteristic curve of the subjects was drawn and analyzed the predictive effect of the relative expressions of the above proteins on bone metastasis within one year after operation in these patients.Results:The positive expression rates of PI3K,p-Akt,p-mTOR,relative expression of PI3K,p-Akt and p-mTOR in cancer tissues were higher than those in adjacent tissues(P<0.05).The incidence of bone metastasis was 27.68%within 1 year after operation.The positive expression rates of PI3K,p-Akt,p-mTOR protein,relative expression of PI3K protein,p-Akt and p-mTOR in bone metastasis patients were higher than those in non-bone metastasis patients(P<0.05).The best cut-off points of PI3K protein,p-Akt and p-mTOR for predicting bone metastasis within one year after operation were 1.25,1.11 and 0.92,respectively.The sensitivity,specificity,accuracy and AUC for predicting bone metastasis within one year after operation were 90.32%,90.12%,82.79%and 0.889 respectively.The sensitivity,accuracy and AUC were higher than those for predicting bone metastasis alone.Conclusion:The expressions of PI3K protein,p-Akt and p-mTOR in gastric cancer tissues are higher,and the expressions of PI3K protein,p-Akt and p-mTOR are higher in patients with bone metastasis within 1 year after operation.The combination of the three factors have a good predictive effect on the incidence of bone metastasis within 1 year after gastrectomy.