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目的研究PI3K/AKT/mTOR信号转导通路相关蛋白PI3K、mTOR、PTEN在脑胶质瘤中的表达及临床意义。方法采用免疫组化Envision二步法检测75例患者的脑胶质瘤标本(胶质瘤组,其中肿瘤分级Ⅱ级30例,Ⅳ级45例)及10名正常人(正常对照组)脑组织PI3K、mTOR、PTEN蛋白的表达,并对脑胶质瘤患者进行生存的相关分析。结果 PI3K、mTOR蛋白在胶质瘤组的阳性率显著高于正常对照组(均P<0.01),PTEN阳性率显著低于正常对照组(P<0.05)。Ⅱ级脑胶质瘤标本中PI3K、mTOR蛋白阳性率显著低于Ⅳ级(均P<0.01),PTEN阳性率显著高于Ⅳ级(P<0.05)。PTEN与PI3K、mTOR蛋白在胶质瘤中的表达分别呈负相关(r=-0.565,P=0.000;r=-0.322,P=0.005);PI3K与mTOR的表达呈正相关(r=0.456,P=0.000)。单因素分析显示,年龄、肿瘤级别、术后放化疗及PI3K蛋白表达影响患者术后的生存时间(r=-0.306,r=-0.422,r=0.392,r=-0.320;均P<0.05)。多因素回归分析显示,肿瘤级别、术后放化疗及PI3K蛋白表达为影响胶质瘤患者预后的独立因素(χ2=17.568,χ2=4.171,χ2=4.427;均P<0.05)。结论脑胶质瘤PI3K、mTOR的表达增高,PTEN的表达降低,并与肿瘤的恶性程度有关。肿瘤级别、术后放化疗及PI3K蛋白表达水平是影响胶质瘤患者预后的独立因素。
Objective To study the expression and clinical significance of PI3K / AKT / mTOR signal transduction pathway related proteins PI3K, mTOR, PTEN in glioma. Methods Immunohistochemical Envision two-step method was used to detect the brain tissue of 75 patients with glioma (glioma group, 30 cases of grade Ⅱ, 45 cases of grade Ⅳ) and 10 normal controls (normal control group) PI3K, mTOR, PTEN protein expression, and glioma patients with survival related analysis. Results The positive rates of PI3K and mTOR in glioma group were significantly higher than those in normal control group (all P <0.01). The positive rate of PTEN in glioma group was significantly lower than that in normal control group (P <0.05). The positive rates of PI3K and mTOR protein in grade Ⅱ glioma were significantly lower than those in grade Ⅳ (all P <0.01). The positive rate of PTEN was significantly higher than that in grade Ⅳ (P <0.05). PTEN was negatively correlated with the expression of PI3K and mTOR in gliomas (r = -0.565, P = 0.000; r = -0.322, P = 0.005). There was a positive correlation between the expression of PI3K and mTOR (r = 0.456, P = 0.000). Univariate analysis showed that the age, tumor grade, chemoradiotherapy and PI3K protein expression affected the postoperative survival time (r = -0.306, r = -0.422, r = 0.392, r = -0.320; . Multivariate regression analysis showed that tumor grade, postoperative radiochemotherapy and PI3K protein expression were independent factors affecting the prognosis of patients with glioma (χ2 = 17.568, χ2 = 4.171, χ2 = 4.427; all P <0.05). Conclusions The expression of PI3K and mTOR in gliomas is increased and the expression of PTEN is decreased, which is related to the malignancy of gliomas. Tumor grade, postoperative radiotherapy and chemotherapy and PI3K protein expression level are independent prognostic factors in patients with glioma.