Expression of phosphorylated Akt (pAkt) in gastric carcinoma predicts prognosis and efficacy of chemotherapy
Expression of phosphorylated Akt (pAkt) in gastric carcinoma predicts prognosis and efficacy of chemotherapy
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DOI：
10.1007/s10120-006-0410-7
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发表时间：
2007-02-01
期刊：
影响因子：
7.4
通讯作者：
Ikeguchi, Masahide
中科院分区：
文献类型：
--
作者：
Murakami, Daiki;Tsujitani, Shunichi;Ikeguchi, Masahide
背景Akt信号通路控制人类癌症的存活和生长。我们研究了磷酸化Akt（pAkt）在胃癌患者中的表达。采用免疫组化法检测140例胃癌手术切除标本中pAkt的表达。根据染色强度评价pAkt的表达，并将染色分为阴性或阳性。我们检测pAkt的表达及其与临床病理特征、预后、浸润深度、p53表达和术后口服氟尿嘧啶化疗疗效的关系。pAkt阳性表达81例（58%），阴性表达59例（42%）。pAkt表达与临床病理结果无明显相关性。pAkt阴性胃癌患者的预后上级优于pAkt阳性胃癌患者，其中T3/T4期胃癌患者的预后差异有统计学意义（P < 0.05）。在T3/T4胃癌患者中，pAkt阳性患者术后口服氟尿嘧啶治疗有效。多因素分析显示pAkt表达和淋巴结转移是独立的预后因素。在88例接受根治性手术的T3胃癌患者中，我们研究了pAkt和p53表达的联合分析对预后的影响，pAkt和p53均阳性的患者的预后显著低于pAkt和p53均阴性或两者均阴性的患者（P <0. 05）。我们的研究结果表明，pAkt表达可能有助于预测胃癌患者的预后和氟尿嘧啶治疗的疗效。
Background. The Akt signaling pathway controls the survival and growth of human cancers. We investigated the expression of phosphorylated Akt (pAkt) in patients with gastric cancer.Methods. The expression of pAkt was immunohistochemically examined in 140 gastric cancer patients who underwent a gastrectomy. The expression of pAkt was evaluated based on staining intensity, and staining was classified as negative or positive. We examined the expression of pAkt and its association with the clinicopathological findings, prognosis, depth of invasion, the expression of p53, and efficacy of oral fluorouracil chemotherapy after surgery.Results. Expression of pAkt was positive in 81 (58%) patients and negative in 59 (42%) patients. There were no significant correlations between pAkt expression and the clinicopathological findings. The prognosis of patients with pAkt-negative tumors was superior to that of patients with pAkt-positive tumors, and the difference was significant for T3/T4 gastric cancer (P < 0.05). Among the patients with T3/T4 gastric cancer, postoperative oral fluorouracil treatment was effective in those who were pAkt-positive. Multivariate analysis revealed that pAkt expression and lymph node metastasis were independent prognostic factors. In 88 patients with T3 gastric carcinoma who had undergone curative surgery, in whom we studied the prognostic impact of a combined analysis of pAkt and p53 expression, patients with both pAkt- and p53-positive tumors showed a significantly poorer prognosis than patients with either or both pAkt- and p53-negative tumors (P < 0.05).Conclusion. Our results indicate that pAkt expression may be useful for predicting the prognosis and efficacy of fluorouracil treatment in patients with gastric cancer.