PI3K/AKT信号通路与乳腺病变弹性特征的相关性

Correlation Between PI3K/AKT Signaling Pathway and Elastic Characteristics of Breast Lesions

目的探讨磷脂酰肌醇-3-激酶/丝苏氨酸蛋白激酶(PI3K/AKT)信号通路与乳腺病变弹性特征的相关性。资料与方法前瞻性分析2021年5月—2022年5月于解放军总医院接受手术的114例患者共115个乳腺病变,术前行超声和剪切波弹性成像检查。采用免疫组化染色检测组织标本中PI3K/AKT蛋白水平的表达,分析染色结果与剪切波弹性成像最大弹性模量值、平均弹性模量值、最小弹性模量值、病变与周围组织弹性比值的相关性。结果115个乳腺病变中,手术病理显示乳腺良性病变50个,恶性病变65个(25个伴腋窝淋巴结转移)。良性病变与恶性病变不伴腋窝淋巴结转移、恶性病变伴腋窝淋巴结转移的最大弹性模量值(F=40.47)、平均弹性模量值(F=45.11)、病变与周围组织弹性比值(F=48.98)、“硬环征”检出率(χ^(2)=62.25)、PI3K/p-PI3K表达水平(F=15.19、58.95)及AKT/p-AKT表达水平(F=46.94、74.21)比较,差异均有统计学意义(P<0.05)。PI3K/pPI3K及AKT/p-AKT表达水平与最大弹性模量值、平均弹性模量值、病变与周围组织弹性比值均呈正相关(r=0.475、0.475、0.451;r=0.533、0.540、0.542;r=0.371、0.402、0.445;r=0.482、0.455、0.545,P均<0.05)。结论乳腺病变的PI3K/AKT表达水平与弹性特征具有相关性,提示其在乳腺病变弹性特征调控中发挥重要作用。

Purpose To explore the correlation between phosphatidylinositol 3 kinase/serine-threonine kinase(PI3K/AKT)signaling pathway and elastic characteristics of breast lesions.Materials and Methods A total of 115 breast lesions were prospectively analyzed in 114 patients who underwent surgery from May 2021 to May 2022 at Chinese PLA General Hospital.Ultrasound and shear wave elastography were performed preoperatively.Immunohistochemical staining was used to detect the expression of PI3K/AKT protein levels in the tissue specimens,and the correlation between the staining results and the elastic parameters of shear wave elastography was analyzed.Results Surgical pathology revealed benign breast lesions in 50 cases and malignant lesions in 65 cases(25 cases with axillary lymph node metastasis).The maximum modulus of elasticity(F=40.47),the average modulus of elasticity(F=45.11),the ratio of elasticity of the lesion to that of the surrounding tissue(F=48.98),the detection rate of“hard ring sign”(χ^(2)=62.25),the expression level of PI3K/p-PI3K(F=15.19,58.95)and AKT/p-AKT(F=46.94,74.21)were found in benign and malignant lesions without axillary lymph node metastasis,malignant lesions with axillary lymph node metastasis(all P<0.05).The expression levels of PI3K/p-PI3K and AKT/p-AKT were positively correlated with the maximum elastic modulus value,the mean elastic modulus value,and the ratio of elasticity of the lesion to the surrounding tissues(r=0.475,0.475,0.451;r=0.533,0.540,0.542;r=0.371,0.402,0.445;r=0.482,0.455,0.545,all P<0.05).Conclusion The expression level of PI3K/AKT in breast lesions is correlated with elastic characteristics,suggesting that it plays an important role in the regulation of elastic characteristics of breast lesions.