【摘要】 目的观察新辅助化疗(NAC)前后胃癌组织中蛋白激酶B(AKT)的表达水平,探讨AKT表达水平及其变化与胃癌NAC疗效的关系。方法对30例胃镜确诊的进展期胃癌患者进行NAC及后续手术治疗,根据肿瘤组织病理学判定标准对术后标本进行化疗效果评估,将所有病例分成有效组和无效组。通过免疫组化检测术前胃镜活检标本及手术切除后肿瘤组织中AKT的表达水平,进而分析化疗前后胃癌组织中.AKT表达水平及其变化与NAC疗效的关系。结果两组患者化疗前AKT表达水平无统计学差异(P>0.05);化疗后所有患者AKT表达水平均较化疗前明显升高,化疗前后比较具有统计学差异(P<0.01);AKT表达水平变化值不同的患者间疗效有统计学差异,变化值小的患者疗效更好(P<0.05),推测AKT表达水平变化值与疗效存在负相关关系。结论胃癌患者NAC后AKT表达水平增高,可能是肿瘤的耐药机制之一,从而可能降低化疗疗效;而化疗后AKT表达水平下降或变化较小的患者对化疗敏感,检测AKT表达水平可帮助预测胃癌对NAC的敏感性。更多还原

【Abstract】 Objective To investigate the expression of AKT in advanced gastric cancer and its relation to the efficacy of neoadjuvant chemotherapy(NAC).Methods Thirty patients with advanced gastric cancer who received NAC and gastrectomy were enrolled in the study.The expression of AKT was detected by immunohistochemistry both in biopsy specimens obtained before treatment and in surgical specimen.The efficacy of chemotherapy was evaluated by pathological criteria,and patients were classified as chemo-effective and chemo-noneffective groups.The correlation between AKT expression and chemo-effectiveness was analyzed.Results There was no significant difference in expression levels of AKT before chemotherapy between two groups(P>0.05).After NAC the AKT expression was significantly increased in the gastric cancer tissue(P<0.01).The variation of AKT expression levels after NAC was negatively correlated with the chemo-effectiveness(P<0.05).Conclusion The elevated expression of AKT after chemotherapy is associated with primary drug resistance,indicating that the detection of AKT may predict the chemo-sensitivity to NAC in gastric cancer patients.更多还原