交通医学
交通醫學
교통의학
MEDICAL JOURNAL OF COMMUNICATIONS
2014年
4期
322-326,330
,共6页
非小细胞肺癌%磷脂酰肌醇3-激酶%磷酸化蛋白激酶B%预后%生存率
非小細胞肺癌%燐脂酰肌醇3-激酶%燐痠化蛋白激酶B%預後%生存率
비소세포폐암%린지선기순3-격매%린산화단백격매B%예후%생존솔
non-small-cell lung carcinoma%phosphatidyl inositol 3-kinase%phosphorylated Akt%prognosis%survival
目的：探讨磷脂酰肌醇3-激酶(phosphatidyl inositol 3-kinase，PI3K)，磷酸化蛋白激酶B(phosphorylated Akt B，p-AKT)在晚期非小细胞肺癌(non-small-cell lung carcinoma，NSCLC)组织中的表达及其与预后的关系。方法：回顾性分析87例晚期NSCLC患者的临床资料，其中鳞癌组37例，腺癌组50例，并收集16例肺癌癌旁正常肺组织标本作为对照组。应用免疫组织化学方法检测PI3K和p-AKT蛋白在癌组织和正常组织中的表达，分析其与患者临床资料变量的关系及其对预后的影响。结果：PI3K和p-AKT在晚期NSCLC中的表达明显高于正常肺组织(P=0.001，0.005)。p-AKT表达与肿瘤的TNM分期呈正相关（P=0.016），而与肿瘤的性别、年龄、病理类型、分化程度、体力状态（PS）评分无关。PI3K表达与上述临床特征无关。PI3K阴性表达组的中位数生存时间明显优于阳性表达组[17.699月(95%CI 15.114-20.283)/13.426月(95%CI 11.832-15.021)，P=0.004]，p-AKT阴性表达组的中位数生存时间明显亦优于阳性表达组[17.134月(95%CI 14.927-19.341)/13.067月(95%CI 11.316-14.817)，P=0.007]。多变量Cox回归分析显示PI3K (HR=2.128，P=0.009)，p-AKT (HR=0.501，P=0.045)，TNM分期(HR=4.808，P<0.001)，PS评分(HR=3.277，P<0.001)是晚期NSCLC的独立预后因素。结论：PI3K、p-AKT与晚期NSCLC不良预后因素密切相关，PI3K、p-AKT是晚期NSCLC预后的独立不利因素。
目的：探討燐脂酰肌醇3-激酶(phosphatidyl inositol 3-kinase，PI3K)，燐痠化蛋白激酶B(phosphorylated Akt B，p-AKT)在晚期非小細胞肺癌(non-small-cell lung carcinoma，NSCLC)組織中的錶達及其與預後的關繫。方法：迴顧性分析87例晚期NSCLC患者的臨床資料，其中鱗癌組37例，腺癌組50例，併收集16例肺癌癌徬正常肺組織標本作為對照組。應用免疫組織化學方法檢測PI3K和p-AKT蛋白在癌組織和正常組織中的錶達，分析其與患者臨床資料變量的關繫及其對預後的影響。結果：PI3K和p-AKT在晚期NSCLC中的錶達明顯高于正常肺組織(P=0.001，0.005)。p-AKT錶達與腫瘤的TNM分期呈正相關（P=0.016），而與腫瘤的性彆、年齡、病理類型、分化程度、體力狀態（PS）評分無關。PI3K錶達與上述臨床特徵無關。PI3K陰性錶達組的中位數生存時間明顯優于暘性錶達組[17.699月(95%CI 15.114-20.283)/13.426月(95%CI 11.832-15.021)，P=0.004]，p-AKT陰性錶達組的中位數生存時間明顯亦優于暘性錶達組[17.134月(95%CI 14.927-19.341)/13.067月(95%CI 11.316-14.817)，P=0.007]。多變量Cox迴歸分析顯示PI3K (HR=2.128，P=0.009)，p-AKT (HR=0.501，P=0.045)，TNM分期(HR=4.808，P<0.001)，PS評分(HR=3.277，P<0.001)是晚期NSCLC的獨立預後因素。結論：PI3K、p-AKT與晚期NSCLC不良預後因素密切相關，PI3K、p-AKT是晚期NSCLC預後的獨立不利因素。
목적：탐토린지선기순3-격매(phosphatidyl inositol 3-kinase，PI3K)，린산화단백격매B(phosphorylated Akt B，p-AKT)재만기비소세포폐암(non-small-cell lung carcinoma，NSCLC)조직중적표체급기여예후적관계。방법：회고성분석87례만기NSCLC환자적림상자료，기중린암조37례，선암조50례，병수집16례폐암암방정상폐조직표본작위대조조。응용면역조직화학방법검측PI3K화p-AKT단백재암조직화정상조직중적표체，분석기여환자림상자료변량적관계급기대예후적영향。결과：PI3K화p-AKT재만기NSCLC중적표체명현고우정상폐조직(P=0.001，0.005)。p-AKT표체여종류적TNM분기정정상관（P=0.016），이여종류적성별、년령、병리류형、분화정도、체력상태（PS）평분무관。PI3K표체여상술림상특정무관。PI3K음성표체조적중위수생존시간명현우우양성표체조[17.699월(95%CI 15.114-20.283)/13.426월(95%CI 11.832-15.021)，P=0.004]，p-AKT음성표체조적중위수생존시간명현역우우양성표체조[17.134월(95%CI 14.927-19.341)/13.067월(95%CI 11.316-14.817)，P=0.007]。다변량Cox회귀분석현시PI3K (HR=2.128，P=0.009)，p-AKT (HR=0.501，P=0.045)，TNM분기(HR=4.808，P<0.001)，PS평분(HR=3.277，P<0.001)시만기NSCLC적독립예후인소。결론：PI3K、p-AKT여만기NSCLC불량예후인소밀절상관，PI3K、p-AKT시만기NSCLC예후적독립불리인소。
Objective:To investigate the expression of phosphatidylinositol 3-kinase(PI3K) and phosphorylated Akt B (p-Akt) protein and its relationship to prognosis in advanced non-small-cell lung carcinoma (NSCLC). Methods:The clini-cal records of 87 patients with advanced NSCLC, consisting of 37 cases with squamous cell carcinoma (SCC) and 50 cases with adenocarcinoma (AdC), together with 16 tumor-adjacent normal tissues, were retrospectively evaluated. PI3K and p-Akt expression were measured by using an immunohistochemical method and its association with clinicopathological data and prognosis were also evaluated. Results:PI3K and p-Akt expression was significantly higher in cancer tissues than that in tumor-adjacent normal tissues (P=0.001,0.005;respectively). The overexpression of p-Akt was only related to TNM stage (P=0.016) and no correlation was observed with gender, age, histological categories, histological grade, and ECOG perfor-mance status. The overexpression of PI3K was not related to the above clinicopathological variables. The survival was sig-nificantly better in patients with PI3K and p-Akt negative expression than with positive expression [17.699 months (95%CI 15.114-20.283)/13.426 months (95%CI 11.832-15.021),P=0.004 and 17.134 months (95%CI 14.927-19.341)/13.067 months (95%CI 11.316-14.817),P=0.007]. Multivariate analysis showed that PI3K (HR=2.128,P=0.009), p-Akt (HR=0.501,P=0.045),TNM stage (HR=4.808,P<0.001) and ECOG performance status (HR=3.277,P<0.001) were independent predictors for survival in advanced NSCLC. Conclusion:PI3K and p-Akt overexpression are independent prognostic mark-ers and potential new therapeutic targets in advanced NSCLC.
