PI3K/Akt/mTOR信号传导通路与泌尿系统肿瘤

PI3K/Akt/mTOR信号传导通路在肿瘤细胞恶性增殖、转移和血管新生以及肿瘤对放、化疗的拮抗中起着重要作用。目前用于泌尿系统肿瘤治疗的方法主要有手术、放疗、化疗和激素疗法,这些方法虽然对早期肿瘤能有效治疗,但是常规治疗无效的病例越来越多,寻找新的治疗方法迫在眉睫。近年来研究发现PI3K/Akt/mTOR信号传导通路与泌尿系统肿瘤的关系密切。因此PI3K/Akt/mTOR途径中众多的受体及激酶都可能成为抗癌药物的潜在靶点。     

肝细胞癌p53基因249密码子热点突变的研究

目的 研究肝细胞癌(HCC)中p53基因249密码子(p53 E7 cd249)点突变情况。方法 用PCR法及HAEⅢ限制性片段长度多态性分析(HAEⅢ/RFLP)检测河南豫东地区38例HCC石蜡包埋组织及2例肝细胞癌株中p53 E7cd249点突变情况,DNA测序证实。选取广西桂西南地区的10例HCC作对照。结果 来自河南豫东地区的HCC p53 E7 cd249点突变率为10.5％(4/38),对照组广西桂西南地区的HCC p53 E7 cd249点突变为40％(4/10),二者相比具有显著性差异(P<0.05)。2例肝细胞癌株中均未发现HCC p53 E7 cd249点突变。结论 河南豫东地区HCC中p53基因E7 cd249点突变为非高发事件;p53 E7 cd249点突变可能发生在肝细胞癌变的晚期。     

IGF-1对Rh1肉瘤细胞PI3K/Akt/mTOR信号通路的影响

目的 探讨胰岛素样生长因子(IGF)1对Rh1肉瘤细胞生长活性和PI3 K/Akt/mTOR信号通路的背景变化.方法 常规细胞培养,用无血清培养基消除内源性因子影响27h,再用IGF-1(终浓度为10 ng/ml)刺激72 h,流式细胞仪检测细胞生长活性;另外Western印迹方法观察IGF-1刺激细胞5、10、20、30和60min后Akt(s473)、S6的动态变化.结果 与对照组相比,IGF-1可促进Rh1细胞存活.IGF-1刺激不同时间后S6磷酸化则随着时间的延长逐渐增强;IGF-1亦导致Akt(s473)位点的磷酸化,随时间的延长,磷酸化Akt在5min时达高峰,此后逐渐减弱.结论 Akt、S6等是PI3K/Akt/mTOR信号通路中的重要信号分子,对Rhl细胞而言,在IGF-1刺激下S6有逐渐增强的变化,Akt (s473)位点磷酸化则有减弱的动态变化.     

Expression of p57(kip2) and its relationship with clinicopathology, PCNA and p53 in primary hepatocellular carcinoma

AIM: To investigate the expression of p57kip2 and its relationship with clinicopathology, PCNA and p53 in primary hepatocellular carcinoma (HCC). METHODS: Expression of p57kip2, PCNA and p53 in tumor tissues from 32 patients with HCC and 10 liver tissues of normal persons was detected with Elivision immunohistochemical technique. RESULTS: The p57kip2 protein positive-expression rate in HCC was 56.25%, lower than that in normal tissues (100%, P<0.05). The reduced expression of p57kip2 protein correlated significantly with moderate or low differentiation of tumor cells (P = 0.007 <0.05), high clinical stage (P= 0.041 <0.05) and poor prognosis (P= 0.036 <0.05), but did not correlate significantly with metastasis, tumor size, level of AFP and age (P>0.05). The PCNA positive-expression rate was 56.25%, which was correlated significantly with the expression of p57kip2 (P= 0.025<0.05). The p53 positive-expression rate was 46.88%, which was not correlated significantly with the expression of p57kip2 (P>0.05). CONCLUSION: There is a marked loss or absence of p57kip2 expression and high expression of PCNA in HCC, which are involved in carcinogenesis and development of HCC. The p57kip2 and p53 may induce apoptosis via different mechanisms.     

Role of p53 suppression in the pathogenesis of hepatocellular carcinoma

In the world, hepatocellular carcinoma (HCC) is among the top 10 most prevalent malignancies. HCC formation has indeed been linked to numerous etiological factors, including alcohol usage, hepatitis viruses and liver cirrhosis. Among the most prevalent defects in a wide range of tumours, notably HCC, is the silencing of the p53 tumour suppressor gene. The control of the cell cycle and the preservation of gene function are both critically important functions of p53. In order to pinpoint the core mechanisms of HCC and find more efficient treatments, molecular research employing HCC tissues has been the main focus. Stimulated p53 triggers necessary reactions that achieve cell cycle arrest, genetic stability, DNA repair and the elimination of DNA-damaged cells’ responses to biological stressors (like oncogenes or DNA damage). To the contrary hand, the oncogene protein of the murine double minute 2 (MDM2) is a significant biological inhibitor of p53. MDM2 causes p53 protein degradation, which in turn adversely controls p53 function. Despite carrying wt-p53, the majority of HCCs show abnormalities in the p53-expressed apoptotic pathway. High p53 in-vivo expression might have two clinical impacts on HCC: (1) Increased levels of exogenous p53 protein cause tumour cells to undergo apoptosis by preventing cell growth through a number of biological pathways; and (2) Exogenous p53 makes HCC susceptible to various anticancer drugs. This review describes the functions and primary mechanisms of p53 in pathological mechanism, chemoresistance and therapeutic mechanisms of HCC.     

Homozygosity for Pro of p53 Arg72Pro as a potential risk factor for hepatocellular carcinoma in Chinese population

AIM: Codon 72 exon 4 polymorphism (Arg72Pro) of the p53 gene has been implicated in cancer risk. Our objective was to investigate the possible association between p53 Arg72Pro polymorphism and susceptibility to hepatocellular carcinoma (HCC) among Chinese population, METHODS: The p53 Arg72Pro genotypes were determined by PCR-based restriction fragment length polymorphism (RFLP) analysis in 507 HCC cases and 541 controls. Odds ratios (ORs) for HCC and 95% confidence intervals (CIs) from unconditional logistic regression models were used to evaluate relative risks. Potential risk factors were included in the logistic regression models as covariates in the multivariate analyses on genotype and HCC. RESULTS: The frequencies for Pro and Arg alleles were 44.5%, 55.5% in HCC cases, and 40.3% and 59.7% in controls, respectively. The Pro allele was significantly associated with the presence of HCC (P = 0.05) and had a higher risk for HCC (OR = 1.19, 95% CI 1.00-1.41) as compared with the Arg allele. After adjusted for potential risk factors, Arg/Pro heterozygotes had an 1.21-fold increased risk (95% CI 0.82-1.78, P= 0.34) of HCC compared with Arg homozygotes, whereas the risk for Pro homozygotes was 1.79 (95% CI 1.06-3.01, P= 0.03) times higher than that for Arg homozygotes. Pro-allele carriers had a higher relative risk of HCC than the Arg-only carriers (adjusted OR = 1.33, 95% CI 0.92-1.92, P = 0.13), although the difference was not statistically significant. CONCLUSION: Homozygosity for Pro of p53 Arg72Pro is potentially one of the genetic risk factors for HCC in Chinese population. The p53 Arg72Pro polymorphism may be used as a stratification marker in screening individuals at a high risk of HCC.     

抑癌基因PTEN及p53在肝细胞肝癌中表达的免疫组化研究

为探讨肝细胞肝癌组织中抑癌基因PTEN及p53蛋白的表达情况及临床病理意义。应用免疫组织化学技术检测了41例肝细胞肝癌及其相应的癌旁组织中PTEN和p53蛋白的表达情况。41例癌旁组织PTEN全部阳性表达,肝细胞肝癌组织中PTEN阳性表达率39％,阳性信号显示于胞浆中。p53阳性表达率51％,PTEN蛋白在肝细胞肝癌组织中的阳性表达与组织分化程度明显相关,高分化癌的阳性率为73％,低分化癌阳性率27％。肝细胞肝癌细胞中存在较高比例的PTEN蛋白阴性表达,说明在肝细胞肝癌的发生发展中PTEN基因失活起着重要作用,它的阳性表达可能有一定的预后意义。     

抑制PI3K/Akt/mTOR信号通路对兔原代巨噬细胞自体吞噬的影响及机制

目的 探讨抑制PI3K/Akt/mTOR信号通路对兔原代巨噬细胞自体吞噬中的影响。方法 分离培养纯种新西兰兔腹腔原代巨噬细胞并分为4组,加入磷脂酰肌醇3激酶（PI3K）抑制剂LY294002（10 μmol/L）组、哺乳动物雷帕霉素靶蛋白（mTOR）抑制剂雷帕霉素（10 nmol/L）组、蛋白激酶B（Akt）抑制剂曲西立滨组（20 μmol/L）以及空白对照组。共培养4 h、12 h后分别收集细胞,运用透射电镜观察巨噬细胞自噬体的变化,细胞免疫荧光法检测微管相关蛋白轻链3Ⅱ（LC3Ⅱ）分子的表达,Western blot检测 Akt、mTOR、磷酸化Akt（p-Akt）、磷酸化mTOR（p-mTOR）及自噬相关蛋白Beclin-1和自噬蛋白Atg5-Atg12连接体的表达,单丹酰尸胺（MDC）染色法观察自噬溶酶体的变化。结果 与空白对照组相比,透射电镜下LY294002组自噬体、自噬空泡、髓磷脂图像等自噬标记物明显减少,雷帕霉素组、曲西立滨组明显增多;激光共聚焦显微镜下LY294002组LC3Ⅱ表达显著减少,雷帕霉素组、曲西立滨组表达显著增多;Western blot结果显示LY294002组Beclin-1及Atg5-Atg12蛋白表达水平显著下降,p-mTOR、p-Akt蛋白表达显著减少;雷帕霉素组、曲西立滨组Beclin-1及Atg5-Atg12蛋白表达水平明显上调,共培养4 h后p-Akt表达增多,雷帕霉素组p-mTOR表达增多,曲西立滨组减少;共培养12 h后雷帕霉素组、曲西立滨组p-mTOR表达显著减少,雷帕霉素组p-Akt表达显著增多,曲西立滨组显著减少;MDC染色显示LY294002组自噬溶酶体明显减少,雷帕霉素组、曲西立滨组明显增多。结论 抑制PI3K/Akt/mTOR信号通路能促进兔原代巨噬细胞自体吞噬,抑制PI3K能减少兔原代巨噬细胞自体吞噬,可能是不同类型的PI3K分子通过其他通路起作用。     

Successful management of postoperative recurrence of hepatocellular carcinoma with p53 gene therapy combining transcatheter arterial chemoembolization

Transcatheter arterial chemoembolization (TACE) has become the standard treatment for unresectable hepatocellular carcinoma (HCC). But this method has some shortages. p53 gene, which was found to be mutant in many human tumors, has been proved with broad spectrum anti-tumor effects. We reported a 23-year-old patient with recurrent HCC after irregular hepatectomy. The p53 gene was applied to this patient. We injected percutaneously and infused transcatheterally p53 gene (Gendicine, Shenzhen Sibiono Bentech, China) into his recurrent nodules in liver respectively and 4 d later, the patient received TACE therapy. In the 2 mo follow-up, the patient was in good clinical condition with normal liver function and no recurrence was identified. The case report proposed that recurrent HCC could be successfully treated with p53 gene therapy combining TACE.     

肝细胞癌抑癌基因p53突变

目的分析重庆地区肝细胞癌ｐ５３基因突变谱．方法住院肝细胞癌患者２０例，皆经病理证实，长期在重庆地区居住，其中早期小肝癌４例，中期６例，晚期１０例．采用ＰＣＲ－ＳＳＣＰ，ＰＣＲ直接测序技术分析ｐ５３基因５，６，７和８外显子突变．结果ｐ５３基因总的突变率为４０％．其中外显子５和６各占１０％，外显子７占２０％，未发现外显子８的突变；测序证实外显子７为第２４９位密码子Ｇ→Ｔ的颠换突变．突变病例多为晚期肿瘤．结论重庆地区肝细胞癌存在明显的ｐ５３基因突变，反映了该地区肝癌与黄曲霉毒素和ＨＢＶ或ＨＣＶ病毒有关     

Clinical significance of p53 antigen and anti-p53 antibodies in the sera of hepatocellular carcinoma patients

Background. To analyze the clinical significance of serum p53 protein and anti-p53 antibodies as serological markers for hepatocellular carcinoma (HCC). Methods. We studied clinical data, i.e., age, sex, etiology, serum alpha-fetoprotein (AFP) level, TMN staging, and Okuda staging in 141 patients with HCC. The sera of these patients were analyzed for serum p53 protein and serum anti-p53 antibodies by enzyme-linked immunosorbent assay (ELISA). Results. Serum p53 antigen and serum anti-p53 antibodies were detected in the sera of 32 of the 141 (22.7%) patients and 26 of the 141 patients (18.4%), respectively. Of note, the HCC patients who were positive for p53 antigen (32/141) had no circulating anti-p53 antibodies. When both these groups of patients were combined as a serum p53 status-positive group, the total number in this group was 58 (41.1%). Positive status of p53 was not associated with age (P = 0.206), serum alpha-fetoprotein level (P = 0.851), Okuda staging (P = 0.243), or survival (P = 0.078), but was correlated significantly with TMN staging (P = 0.049). Interestingly, a shorter survival time (mean, 3.9 months) was noted in the serum p53 status-positive group, in comparison with the longer survival time (mean, 6.5 months) in the serum p53 status-negative group. Conclusions. Combination of the detection of serum p53 antigen and antibodies by ELISA may represent a suitable noninvasive investigation in assessing the clinical implications and prognoses of patients with HCC. Received: December 8, 2000 / Accepted: June 22, 2001     

Relationship between therapeutic efficacy of arterial infusion chemotherapy and expression of P-glycoprotein and p53 protein in advanced hepatocellular carcinoma

AIM:TO investigate the relationship between thechemotherapeutic drug efficacy and the expressionof P-glycoprotein(PGP)and p53 protein in advancedhepatocellular carcinoma(HCC).METHODS:The study was conducted on 41 patientswith advanced HCC who were treated by repeatedarterial infusion chemotherapy.Biopsy specimens fromthe tumor were collected before the start of treatmentin all the patients,and the specimens were storedfrozen until immunohistochemical staining,which wasperformed after the start of treatment,to detect PGPand p53 protein expressions.Twenty of the forty-one patients were treated with an anthracycline drug(epirubicin hydrochloride;anthracycline group),andthe remaining 21 were treated with a non-anthracyclinedrug(mitoxantrone hydrochloride in 11 patients andcarboplatin in 10 patients;non-anthracycline group).Therelationship between the chemotherapeutic efficacy andthe results of immunostaining were compared betweenthe two groups.RESULTS:Before the start of the treatment,PGP-positive rate was 90.2%(strongly-positive,36.6%)andp53 protein-positive rate was 34.1%(strongly-positive,19.5%).In the anthracycline group,the response ratewas 40.0%.The number of patients showing poorresponse to the treatment was significantly larger in thepatients with strongly positive PGP expression(P=0.005),and their prognoses were poor(P=0.001).In the non-anthracycline group,the response rate was 42.9%, and there was no significant relationship between thechemotherapeutic drug efficacy and the PGP or p53protein expression.When only the data from the 11patients treated with anthraquinone drug,mitoxantrone,were analyzed,however,the number of patients whoshowed poor response to treatment was significantlyhigher among the p53-positive patients(P=0.012),irrespective of the survival outcome.CONCLUSION:The chemotherapeutic efficacy with ananthracycline drug for advanced HCC can be predictedby immunohistochemical analysis of PGP expression.Similarly,immunostaining to evaluate p53 protein maybe useful to predict the response in patients treated withan anthraquinone drug.     

Aflatoxin and p53 abnormality in duck hepatocellular carcinoma

Recent studies have revealed that a point mutation at codon 249 in the p53 gene predominates in hepatocellular carcinoma (HCC) cases from Southern Africa and China, where infection with hepatitis B virus (HBV) and contamination of aflatoxin B₁ in food are risk factors for HCC. This unique mutation from G to T at the third base in codon 249 observed in human HCC cases is suggested to be linked to aflatoxin exposure. Six ducks with HCC, five of which were fed a diet containing aflatoxin B₁ for 1–2 years, were analysed for the presence of point mutations at this codon of the p53 gene by polymerase chain reaction and direct nucleotide sequencing. None of the six ducks with HCC showed the change at this codon regardless of duck hepatitis B virus infection. This suggests that aflatoxin B₁ itself might not be involved in the unique mutation at codon 249 in hepatocar-cinogenesis, or that other factors coincident with aflatoxin may be responsible for this unique mutation.     

Aflatoxin sufferer and p53 gene mutation in hepatocellular carcinoma

Ａｆｌａｔｏｘｉｎｓｕｆｅｒｅｒａｎｄｐ５３ｇｅｎｅｍｕｔａｔｉｏｎｉｎｈｅｐａｔｏｃｅｌｕｌａｒｃａｒｃｉｎｏｍａＤＥＮＧＺｈｕｏＬｉｎａｎｄＭＡＹｕｎＳｕｂｊｅｃｔｈｅａｄｉｎｇｓＡｆｌａｔｏｘｉｎＢ１;ｇｅｎｅｓ,ｐ５３;ｍｕｔａｔｉｏｎ;...     

The expression of the mdm2 gene may be related to the aberration of the p53 gene in human hepatocellular carcinoma

The relationship between mdm2 gene expression and p53 gene mutation in hepatocellular carcinoma (HCC) and their correlation with the invasiveness of the disease were investigated in this study. Either the expression level of the mdm2 gene or the mutation rate of the p53 gene was higher in HCC than in paratumor liver tissues. Studies on the relationship between mdm2 and p53 revealed that mdm2 gene expression in HCC without p53 mutation was higher than when there was p53 mutation, while the p53 mutation rate in HCC with mdm2 overexpression was significantly lower than in HCC without mdm2 overexpression. Among 23 HCC with invasion, mdm2 gene overexpression was found in 6 patients while p53 mutation was found in the other 11 patients, and only 1 patient was found to have both mdm2 overexpression and p53 mutation. These results indicated that either mdm2 overexpression or p53 mutation may be related to the invasiveness of HCC. Considering that an autoregulatory feedback loop between the mdm2 and p53 genes may exist, wild-type P53 can induce the expression of mdm2 via a p53-binding site in the mdm2 gene, while MDM2 protein functions as a negative regulator of P53 protein. These results also suggest that mdm2 may be related to the high invasiveness of HCC through inactivating the tumor-suppressor function of the p53 gene. Received: 8 September 1997 / Accepted: 17 December 1997     

p53对肝癌P-糖蛋白的表达和耐药表型的影响

目的 证明野生型p53调节肝癌细胞P－糖蛋白（p-glycoprotein,P-gp)表达的设想。方法 通过采用脂质体介导转染技术,将野生型p53 cDNA导入一种p53和Rb基因缺失的肝癌细胞株Hep3B。结果 经G418筛选获得稳定整合了野生型p53的克隆（wt-p53)和空载体克隆（pNeo);经northern和western印迹鉴定,wt-p53细胞表达p53;p21waf1/cip1蛋白的升高证实wt-p53细胞的p53有转录活性,并致使P－gp表达降低。细胞毒性试验表明：与pNeo细胞相比,wt-p53细胞对阿霉素和丝裂霉素化疗敏感。流式细胞仪显示：wt-p53细胞的阿霉素荧光量为pNeo细胞的13倍。结论 在肝癌细胞Hep3B中重建野生型p53的活性由于降低P－gp的表达而对化疗药敏感。     

High levels of p53 protein expression do not correlate with p53 mutations in hepatocellular carcinoma

To determine the relationship between p53 altered expression and p53 mutations in hepatocellular carcinoma (HCC), we analysed p53 protein immunohistochemically and assessed the presence of mutations in exons 4-8 of the p53 gene using SSCP assay in 117 HCCs corresponding to 78 patients. We also determined the relationship of p53 expression with cellular proliferation by immunostaining with monoclonal antibodies to Ki-67. We found significant levels of p53 protein expression in 23.1% of the 117 cases studied, but identified mutations in only 12 cases (10.3%). Only four of the p53-positive cases had mutations in the regions analysed. Six of the cases that displayed mutations at p53 gene were negative for immunohistochemical analysis (IHC) and two cases showed positive immunoreactivity in the cytoplasm of the cell. In conclusion, strong IHC reactivity for p53 protein is not an indicator of the presence of p53 gene mutations at exons 4-8 in HCC. Thus, p53 loss of function in HCC should be evaluated both by p53 mutation analysis and p53 protein expression, as both give complementary information about p53 status.