腋窝淋巴结阴性乳腺癌组织中PTEN、p-Akt、P-gp表达及意义

目的进一步探讨磷酸化Akt（p-Akt）、人第10号染色体缺失的磷酸酶及张力蛋白同源的基因（PTEN）及多药耐药蛋白P-糖蛋白（P-gp）在乳腺癌发生、发展中的作用。方法采用免疫组化法检测81份腋窝淋巴结阴性（LNN）乳腺浸润性癌组织标本中p-Akt、FIEN及P-gp表达，采用四格表的，检验、确切概率法和Cox比例风险模型分析三者与乳腺癌临床病理因素的关系。结果LNN乳腺癌组织中p-Akt阳性表达率明显高于癌旁组织（P=0．034）；PTEN阳性表达率显著低于癌旁组织（P=O．001）；p-Akt过表达与PTEN低表达均与肿瘤分化、雌激素受体（ER）阴性、复发转移和5年生存率有关。P-gp在LNN乳腺癌组织中阳性表达率为39．5％，与肿瘤复发转移显著有关。多因素分析发现，p-Akt和PTEN是影响预后的独立因素，且p-Akt与P-gp表达呈正相关（r=0．548，P=0．045）。结论p-Akt、PTEN及P-gp均参与了乳腺癌的发生、发展，检测三者水平有助于患者预后判断。

Expression and significance of p-Akt,PTEN and P-gp in patients with axillary node negative breast cancer

Objective To investigate the effects of phospho-Akt （p-Akt）, phosphatase and tensin homolog deleted on chromosome ten（PTEN） and P-glycoprotein（P-gp） in the occurrence and development of breast cancer. Methods A series of 81 primary axillary lymph node negative （LNN） breast cancer specimens were performed by immunohistochemica] staining to detect the expression of p-Akt, PTEN and P-gp. The correlation between the three indexes and clinicopathological factors of breast cancer were analyzed byx2-test, exact propability and Cox＇s proportional hazard model. Results A marked increased activity of p-Akt was detected in breast cancer, which was significantly higher than that in normal breast tissues（ P = 0. 034）. The PTEN expression was 63.0%, which was significantly lower than that in normal tissues （P = 0.001 ）. The overexpression of p-Akt and loss of PTEN was related with tumor differentiation, ER negative, recurrence, metastasis and 5-years survival rates. The positive rate of P-gp was 39.5%, related with recurrence and distant metastasis. Multivariate analysis found that p-Akt expression was also sig~figicanfly positively correlated with P-gp expression （r = 0.548 ,P = 0.045 ）, and also expression of p-Akt （P = 0.04） and PTEN （P = 0.02 ） were independent prognostic factors for prognosis of LNN breast cancer. Conclusions P-Akt, PTEN and P-gp may play certain effects in the occurrence and development of breast cancer, to detect the level of the three indexes is helpful for the prognosis evaluation.