ErbB2／Grb2／mTOR通路在胃癌发生发展中的作用

目的：检测ErbB2／neu、Grb2和mTOR胃癌中的表达并探讨ErbB2／Grb2／mTOR通路在胃癌发生发展中的作用。方法：构建含有1072例胃癌的组织芯片，利用免疫组化检测ErbB2／neu、Grb2和mTOR在胃癌中的表达。结果：ErbB2／neu、Grb2和mTOR在胃癌中的表达率分别为30．2％、47．5％和50．8％。ErbB2／neu和Grb2的过度表达与年龄（〉60岁）、肿瘤部位、肿瘤类型和高分化相关（P〈0．01）；mTOR的过度表达与肿瘤部位、肿瘤类型、高分化、T分期和TNM分期相关（P〈0．05）。Spearman相关性检验显示，3个蛋白两两之间存在显著相关（P〈0．001）。单因素生存分析表明，Grb2和mTOR与预后有关（P=0．0067，P=0．0001）；而在Cox回归多因素分析中，roTOR与预后有关（P=0．046）。结论：ErbB2／Grb2／mTOR通路在胃癌的发生发展中起到极其重要的作用，mTOR还可能作为胃癌患者预后的独立指标。3个蛋白可以作为胃癌治疗的靶点，继而为胃癌的治疗开拓新的思路。

The role of ErbB2/Grb2/mTOR pathway in gastric carcinoma

Objective:To detect the expression of ErbB2/neu,Grb2 and mTOR in gastric carcinoma and to investigate their roles in the carcinogenesis of gastric cancer.Methods:Tissue microarrays containing 1 072 cases were constructed and immunohistochemistry was used to detect the expression of ErbB2/neu,Grb2,and mTOR proteins in gastric cancers.Results:The rates of ErbB2/neu,Grb2,and mTOR positive expression were 30.2%,47.5% and 50.8%,respectively.ErbB2/neu and Grb2 overexpression was significantly associated with age,tumor location,adenocarcinoma and differentiation.Overexpression of mTOR was significantly related to tumor location,adenocarcinoma,differentiation,T and TNM stage.Significant relationship was seen in every two proteins.Univariate analysis showed that Grb2 and mTOR were predictors of patient outcome.Multivariate analysis revealed that mTOR were independent prognostic factors of patients with gastric carcinoma.Conclusion:ErbB2/Grb2/mTOR pathway plays a critical role in the development and progress of gastric cancer.mTOR was an independent prognostic factor of patients with gastric carcinoma.These proteins prove to be the promising therapeutic targets of gastric carcinoma.