p-Akt在恶性黑素瘤中的表达及意义探讨

目的 探讨p-Akt（Ser-473）表达水平与恶性黑素瘤的临床和病理学参数的关系。方法 应用免疫组化方法检测21例恶性黑素瘤患者手术切除的肿瘤标本中p-Akt的表达，以21例色素痣作对照，分析其与恶性黑素瘤的临床特征及预后的关系。结果 p-Akt在转移性黑素瘤的表达阳性率（67%）高于原发性黑素瘤（56%），而在色素痣中表达阴性，三组间的表达阳性率差异有统计学意义（P < 0.05）。肿瘤浸润深度及年龄与p-Akt表达率呈显著正相关（r值分别为0.41和0.53，P均 < 0.05）。p-Akt的强表达与恶性黑素瘤患者的5年生存率显著相关（r = 0.41，P < 0.05），而高危黑素瘤（浸润厚度 > 1.5 mm）患者中p-Akt的强表达与生存率的相关性更为显著（OR = 2.586，95%可信区间为0.906 ～ 7.382，P < 0.05）。结论 p-Akt的表达随着恶性黑素瘤的浸润程度和进展显著提高，并与患者的5年生存率密切相关。此外，p-Akt可能有利于判断高危黑素瘤患者的预后。

Expression and significance of phospho-Akt in malignant melanoma

Objective To investigate the expression of phospho-Akt (p-Akt)in malignant melanoma(MM)and its relationship to the clinical and pathological features of MM.Methods Tissue samples were resetted from 21 patients with MM collected from January 1994 to August 2006 in Sir Run Run Shaw Hospital.Samples from 21 patients with pigmented nevus served as control.Information about tumor staging,metastasis,invasion depth as well as patients'age and postoperative 5-year survival rate was collected.Immunohistochemistry was used to measure the expression of p-Akt in tbe above samples.The correlation of P-Akt expression with the clinical features and prognosis of MM was evaluated.Results There was no expression of P-Akt in pigmented nevus tissue,and an increase was noticed in p-Akt expression in metastastic melanoma compared with primary melanoma(67% vs 56%,P＜0.05).Furthermore,both the invasion depth of MM and age of patients with MM significantly correlated with p-Akt expression(r=0.41,0.53 respectively,both P＜0.05).As the Kaplan-Meier survival curves showed,the strong expression of p-Akt was highly correlated with the post-operative 5-year survival rate of patients with MM (r=0.41,P＜0.05).Multivariate Cox regression analysis also revealed a strong correlation(OR=2.586,95% CI 0.906 to 7.382,P=0.016)between the overexpression of p-Akt and survival rate in patients with high risk MM(invasion depth＞1.5 mm).Conclusions The expression of p-Akt increases dramatically with the depth of invasion and with exacerbation of MM,but inversely correlated with the 5-year survival rate of patients.Consequently,p-Akt may help to predict the prognosis of patients with high risk MM.