直肠癌组织中mTOR和VEGF的表达与侵袭转移及预后的关系

目的 探讨直肠癌组织中哺乳动物雷帕霉素靶蛋白（mTOR）和血管内皮生长因子（VEGF）的表达，并分析其与侵袭转移和预后的关系。方法 采用免疫组化SP法检测mTOR和VEGF在60例直肠癌、30例直肠腺瘤及10例正常直肠黏膜组织中的表达，并对直肠癌中两者与临床病理特征、预后及两者间的相关性进行分析。结果 mTOR在直肠癌中的阳性表达率为60.0％（36／60），高于直肠腺瘤和直肠正常黏膜组织的36.7％（11／30）和10.0％（1／10），差异均有统计学意义（P＜0.05）；其表达与直肠癌患者的术前CEA水平、分化程度、TNM分期、淋巴结转移和远处转移有关（P＜0.05），而与年龄、性别、肿瘤部位和肿瘤形态无关（P＞0.05）。VEGF在直肠癌中的阳性表达率为70.0％（42／60），显著高于直肠腺瘤和直肠正常黏膜组织的46.7％（14／30）和20.0％（2／10），差异均有统计学意义（P＜0.05）；其表达与直肠癌患者的TNM分期、淋巴结转移和远处转移有关（P＜0.05），而与年龄、性别、肿瘤部位、肿瘤形态、术前CEA水平和分化程度无关（P＞0.05）。两者在直肠癌组织中的表达呈正相关（r=0.393，P=0.002）。60例直肠癌患者的中位生存期为39.2个月，1、2、3年生存率分别为89.4%、76.6%和55.3%。单因素生存分析显示，术前CEA水平、TNM分期、淋巴结转移、远处转移与直肠癌预后有关（P＜0.05），而年龄、性别、肿瘤部位、分化程度、肿瘤形态、VEGF、mTOR与直肠癌预后无关（P＞0.05）。结论 直肠癌组织中 mTOR、VEGF均呈高表达，且呈正相关，二者在直肠癌侵袭转移中可能发挥重要作用。

Correlation of mTOR and VEGF expressions with invasion, metastasis and prognosis in rectal cancer

Objective To detect the expressions of mammalian target of rapamycin（mTOR） and vascular endothelial growth factor （VEGF） in rectal cancer, and analyze the correlation of them with invasion, metastasis and prognosis of rectal cancer. Methods Immunohistochemistry was used to detect the expressions of roTOR and VEGF in 60 cases of rectal cancer, 30 cases of rectal adeno- ma and 10 cases of normal rectal tissues. The correlation of mTOR and VEGF with clinicopathologic features, prognosis and the rela- tionship between them were analyzed. Results The positive expression rate of mTOR in rectal cancer was 60. 0% （36/60） , higher than 36. 7% （ll/30）in rectal adenoma and 10. 0% （1/10） in normal rectal tissues with significant difference（P 〈0. 05）. It was sig- nificantly correlated with preoperative CEA level, tumor differentiation, TNM stage, lymph node metastasis and distant metastasis（ P 〈 0. 05 ） , but not with gender, age, tumor location and tumor morphology （ P 〉 0. 05 ）. The positive expression rate of VEGF in rectal cancer was 70. 0% （42/60）, higher than 46. 7% （14/30） in rectal adenoma and 20. 0% （2/10） in normal rectal tissues with significant difference（ P 〈 0. 05 ）. It was significantly correlated with TNM stage, lymph node metastasis and distant metastasis （P 〈 0. 05 ）, but not with gender, age, tumor location, tumor morphology, preoperative CEA level and tumor differentiation （ P 〉 0.05 ）. The expression of mTOR and VEGF in rectal cancer tissues were positively correlated（ r = 0. 393, P = 0. 002 ）. The median overall survival of rectal cancer patients was 39. 2 months, and the 1-, 2-, 3-year survival rates were 89. 4%. 76. 6% and 55. 3%. Kaolan-Meier method showed that preoperative CEA level, TNM stage, lymph node metastasis, distant metastasis were correlated with rectal cancer prognosis （P 〈 0. 05）, while age, gender, tumor position, differentiation, tumor morphology and the expressions of mTOR and VEGF were not correlated with prognosis. Conclusion mTOR and VEGF have high expression rates in rectal cancer and positively correlated, and they may play an important role in the invasion and metastasis of rectal cancer.