雷帕霉素靶蛋白在皮肤鳞状细胞癌及癌前病变中的表达及意义

Expression and significance of mTOR in cutaneous squamous cell carcinoma and precancerous lesion

目的 探寻哺乳动物雷帕霉素靶蛋白(mammalian target of rapamycin,mTOR)在皮肤鳞状细胞癌(cutaneous squamous cell carcinoma,CSCC)、鲍温病(Bowen’s disease,BD)和光线性角化病(actinic keratosis,AK)中的作用及与肿瘤增殖程度的关系。方法 收集本院CSCC、BD、AK的石蜡标本各42例,选取整形外科手术切除的正常皮肤42例作为对照组,进行免疫组化染色,观察mTOR、Ki-67在组织中的表达。结果 CSCC组中mTOR阳性表达率高于BD组和AK组(P<0.0.05);CSCC组中Ki-67阳性表达率高于AK组,上述差异均有统计学意义(P<0.01);Logistic回归分析显示,发病部位、病程、分化程度是mTOR阳性表达的独立影响因素(P<0.05);CSCC、BD、AK中mTOR与Ki-67的表达水平呈正相关(r值分别为0.836、0.619、0.372,P<0.05)。结论 mTOR在CSCC的阳性表达明显高于BD、AK,mTOR可能参与CSCC的发病;mTOR与CSCC增殖程度相关,可以作为反映CSCC增殖状态的一个指标。

Objective To investigate the role of mTOR in cutaneous squamous cell carcinoma(CSCC),Bowen􀆳s disease(BD),actinic keratosis(AK)and the correlation between mTOR and tumor proliferation.Methods Each 42 cases of CSCC,BD,and AC tissues were collected.Forty-two cases of normal skin resected by plastic and cosmetic surgery were used as a control group.Immunohistochemical staining was performed to observe the expression of mTOR and Ki-67 in tissues.Results The positive expression rate of mTOR in CSCC group was higher than that in BD group and AK group(P<0.05).The positive expression rate of mTOR in BD group and AK group was higher than that in normal skin group(P<0.05).The positive expression rate of Ki-67 in the CSCC group was higher than that in the AK group,with the difference statistically significant(P<0.01).The Logistic regression analysis showed that location,duration,degree of differentiation were independent risk factors for the positive expression of mTOR(P<0.05).The levels of mTOR in CSCC,BD and AK were positively correlated with the level of Ki-67(r=0.836,r=0.619,r=0.372,P<0.05).Conclusion The positive rate of mTOR in CSCC group was higher than that in BD group and AK group.mTOR may be involved in the occurrence and development of CSCC.The positive degree of mTOR is related to the proliferation degree of CSCC.mTOR can be used as an indicator to reflect the state of CSCC proliferation.