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目的探讨老年上皮性卵巢癌组织中磷酸化-AKT(p-AKT)和P-糖蛋白(P-gp)表达与卵巢癌化疗反应及预后的关系。方法采用免疫组化SP法检测63例上皮性卵巢癌组织和20例正常卵巢组织中p-AKT和P-gp表达,分析其与化疗反应的关系,同时对预后进行多因素的Cox生存分析。结果p-AKT和P-gp在上皮性卵巢癌组织中阳性表达率分别为52.4%和31.7%,显著高于正常卵巢组织(P<0.01),且p-AKT和P-gp表达存在相关性。p-AKT和P-gp表达阳性组的化疗反应率显著高于p-AKT和P-gp表达阴性组(P<0.001)。多因素生存分析显示,年龄≥60岁、手术病理分期、术后残留灶直径≥2cm是影响患者预后的独立危险因素。结论p-AKT和P-gp阳性表达与上皮性卵巢癌组织化疗耐药有关,p-AKT过表达对P-gp阳性表达可能具有促进作用,在卵巢癌化疗耐药中起重要作用,对合理制定化疗方案、预测化疗反应性及估计预后具有积极的指导意义。
Objective To investigate the relationship between the expression of phosphorylated-AKT (P-AKT) and P-glycoprotein (P-gp) and the chemotherapy response and prognosis in patients with epithelial ovarian cancer. Methods The expressions of p-AKT and P-gp in 63 cases of epithelial ovarian cancer and 20 cases of normal ovarian tissue were detected by immunohistochemical SP method. The relationship between the expression of p-AKT and P-gp was analyzed and the multi-factor Cox survival analysis of prognosis was performed. Results The positive rates of p-AKT and P-gp in epithelial ovarian cancer tissues were 52.4% and 31.7%, respectively, which were significantly higher than those in normal ovarian tissues (P <0.01). There was a correlation between the expression of p-AKT and P-gp . The response rate of chemotherapy in p-AKT and P-gp positive group was significantly higher than that in p-AKT and P-gp negative group (P <0.001). Multivariate survival analysis showed that age ≥ 60 years of age, surgical pathology, postoperative residual tumor diameter ≥ 2cm is an independent risk factor affecting the prognosis of patients. Conclusions The positive expression of p-AKT and P-gp is related to chemoresistance in epithelial ovarian cancer tissues. Overexpression of p-AKT may promote the expression of P-gp and play an important role in chemoresistance of ovarian cancer. The development of chemotherapy regimens, predict the reactivity of chemotherapy and prognosis have a positive guiding significance.