卵巢上皮性癌组织中磷酸化蛋白激酶B和PTEN蛋白的表达及其意义

目的探讨磷酸化蛋白激酶B（pAKT）和FYEN蛋白在卵巢上皮性癌（卵巢癌）组织中的表达及其相互关系,并分析两者与卵巢癌患者预后的关系。方法应用免疫组化法,检测12份正常卵巢、20份卵巢良性上皮性肿瘤、12份卵巢交界性上皮性肿瘤、80份卵巢癌组织中pAKT和PTEN蛋白的表达,并分析两者间的关系。采用单因素和多因素生存分析法分析pAKT和FYEN蛋白表达与卵巢癌患者预后的关系。结果pAKT蛋白在正常卵巢、卵巢良性上皮性肿瘤组织中的阳性表达率分别为8％、10％。显著低于卵巢癌组织的55％（P〈0．01）;而FYEN蛋白在卵巢癌组织中的阳性表达率为45％,显著低于正常卵巢和良性上皮性肿瘤组织的100％、80％（P〈0．01）。pAKT和FYEN蛋白在交界性肿瘤组织中的阳性表达率分别为25％、67％,分别与卵巢癌组织比较,差异均无统计学意义（P〉0．05）。pAKT和FYEN蛋白表达与卵巢癌手术病理分期、病理分级、有无淋巴结转移和远处转移有关（P〈O．05）,而与年龄、病理类型、有无腹水无关（P〉0．05）。卵巢癌组织中pAKT和PTEN蛋白间的表达呈明显负相关关系（r=-0．444,P〈0．01）。单因素生存分析显示,手术病理分期、病理分级、有无淋巴结转移和远处转移、pAKT和FrEN蛋白阳性表达与患者预后有关（P〈0．05）。Cox回归多因素分析表明,FYEN蛋白阳性表达和手术病理分期是影响卵巢癌患者预后的独立危险因素（P〈0．05）。结论pAKT蛋白过度表达伴随PTEN蛋白表达缺失可能参与卵巢癌的发生、发展,PTEN蛋白表达缺失是卵巢癌患者预后不良的独立危险因素。

Expression of phosphorylated protein kinase B and PTEN protein in ovarian epithelial cancer

OBJECTIVE: To analyze the expression of phosphorylated protein kinase B (pAKT) and PTEN protein in ovarian epithelial cancer and to investigate the correlations between their expression and prognosis of ovarian epithelial cancers. METHODS: Expression of pAKT and PTEN in 12 normal ovarian tissues, 20 benign tumors, 12 borderline tumors and 80 cases of ovarian epithelial cancers were detected by immunohistochemical method, and their correlations were analyzed. RESULTS: The positive expression of pAKT in normal ovarian and benign tumor tissues were significantly lower than that in ovarian epithelial cancers (8%, 10% vs 55%; P < 0.01), respectively. However, loss of PTEN expression in ovarian epithelial cancers was significantly higher than that in normal ovarian and benign tumor tissues, and the positive rate of PTEN expression were respectively, 45%, 100%, and 80% (P < 0.01). The expression of pAKT and PTEN were correlated with clinical stages, differentiation degree of cancer cells, and metastasis (including lymph node; P < 0.05). But there was no difference with regard to age, histological type and ascites. In ovarian cancers, a negative correlation between expression of pAKT and PTEN was observed (r = -0.444, P < 0.01). A univariate analysis revealed that clinical stage, differentiation degree, lymph node involvement, distant metastasis, pAKT and PTEN expression were correlative factors with prognosis (P < 0.05). Multivariate Cox analysis showed that PTEN and clinical stage were the independent risk factors of prognosis (P < 0.05). CONCLUSIONS: The overexpression of pAKT and absence of PTEN are related to ovarian carcinogenesis and development. Loss of PTEN expression is the independent risk factor of poor prognosis in patients with ovarian epithelial cancers.