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目的:分析磷脂酰肌醇-3激酶催化亚基δ(phosphoinositide-3 kinase,catalytic subunit delta,PIK3CD)表达与胃癌临床病理特征和患者预后的相关性。方法:收集2004年5月至2007年12月在辽宁医学院附属第一医院胃肠外科行肿瘤切除并经病理证实的胃癌患者癌组织标本及相应癌旁组织标本各86例,采用免疫组织化学法检测PIK3CD蛋白在86例胃癌及癌旁组织中的表达;利用χ2检验及Spearman相关性检验探讨PIK3CD表达与胃癌临床病理特征的关系;应用Kaplan-Meier方法分析PIK3CD表达与胃癌患者术后5年生存率及生存时间。结果:相对于癌旁组织,PIK3CD在胃癌组织中的表达明显上调(P=0.006);PIK3CD表达与胃癌浸润深度呈显著相关性(P=0.005),与淋巴结阳性率(P=0.089)和临床分期(P=0.060)有相关趋势但无统计学意义,而与肿瘤大小、组织分化程度、淋巴结和远处转移等无相关性。高表达和低表达PIK3CD的患者术后5年累积生存率分别为18.9%和60.6%,中位生存时间为31.0(95%CI:23.9~38.1)个月和60.6(95%CI:53.8~67.4)个月,Kaplan-Meier分析显示其差异有显著统计学意义(χ2=19.791,P=0.000)。多因素分析显示,PIK3CD可作为一个独立的预后评估因素(P=0.000)。结论:(1)胃癌组织中PIK3CD表达的显著上调提示其具有潜在的促癌作用;(2)PIK3CD表达上调与胃癌的浸润程度和患者生存时间相关,可作为胃癌预后不良评估的一个独立影响因素。
OBJECTIVE: To analyze the relationship between the expression of phosphoinositide-3 kinase (PIK3CD) and the clinicopathological features and prognosis of gastric cancer. Methods: Totally 86 gastric cancer specimens and corresponding adjacent normal tissues were collected from the Department of Gastrointestinal Surgery, the First Affiliated Hospital of Liaoning Medical University from May 2004 to December 2007, and confirmed by pathology. Immunohistochemistry Method was used to detect the expression of PIK3CD protein in 86 cases of gastric cancer and its adjacent tissues. The relationship between PIK3CD expression and clinicopathological features of gastric cancer was analyzed by Chi-square test and Spearman correlation test. Kaplan-Meier method was used to analyze the relationship between PIK3CD expression and gastric cancer 5 years Survival and survival time. Results: The expression of PIK3CD in gastric cancer tissues was significantly up-regulated (P = 0.006) compared with that in paracancerous tissues. There was a significant correlation between the expression of PIK3CD and the depth of gastric cancer invasion (P = 0.005) Staging (P = 0.060) was associated with trends but not statistically significant, but not related to tumor size, degree of tissue differentiation, lymph nodes and distant metastases. The 5-year cumulative survival rates of patients with high and low expression of PIK3CD were 18.9% and 60.6%, respectively. The median survival time was 31.0 (95% CI: 23.9-38.1) months and 60.6 (95% CI: 53.8-67.4) ) Months, Kaplan-Meier analysis showed that the difference was statistically significant (χ2 = 19.791, P = 0.000). Multivariate analysis showed that PIK3CD was an independent prognostic factor (P = 0.000). Conclusions: (1) The significant up-regulation of PIK3CD expression in gastric cancer suggests that it may have a potential role in promoting cancer. (2) The upregulation of PIK3CD and the infiltration of gastric cancer correlate with the survival time of patients and may be used as an independent influencing factor for poor prognosis of gastric cancer .