Correlational Analysis Between The Prognosis Of Colon Carcinoma And The Expression Of PTEN And PI3K

Object：The important role of PTEN/PI3K/Akt signal transduction pathway in thegenesis and development of tumor has received more and more attention, meanwhile,the expression of the gene in the pathway has shown to be markers for predicting theprognosis of tumor. As China’s standard of living improved, the incidence of coloncancer has been increasing year by year, therefore the diagnosis, treatmentand prognosis of colon cancer become more important. The present study ofPTEN/PI3K/Akt pathway of colon carcinoma was relatively less, so we want to studyon expression of PTEN, PI3K of PTEN/PI3K/Akt signal transduction pathway incolon carcinoma and normal colon tissue, analyzing the connection between theexpression and the toxic side effects，the clinicopathological factors，prognosis ofcolon carcinoma, discussing the relationship of their expression in colon carcinoma toexplore its roles in the occurrence、prognosis and individual treatment in colon cancer.Methods: We selected45patients with colon adenocarcinoma pathologicallyconfirmed after operation from January2008to December2011in First AffiliatedHospital of Dalian Medical University.All patients received standard postoperativechemotherapy with FOLFOX for8-12cycles, with totally408cycles, and the meanwas10.72cycles. There were42cases performed immunohistochemical experiments,with completed clinical data, could be included in the study group, including32males and10females,30cases staged in the left colon，12cases staged in the right colon，aged38years old to75years old, with a median age of50.5years old,37cases elderthan50years old,5cases younger than50years old;7cases of well-differentiated，21cases of moderately differentiated,14cases of poorly differentiated; lymph nodemetastasis in23cases, without lymph node metastasis in19cases; distant metastasisin17cases, hepatic metastasis in13cases, pulmonary metastasis in3cases, peritonealmetastasis in1case, without distant metastasis in25cases. There was no case deadwith toxic side effects. Follow-up was the date of surgery to the date of recurrence.The last follow-up date was May2013. Another42cases from the normal colonictissue had been a control group.2. Using immunohistochemistry to investigate theexpression of PTEN and PI3K in the study group and the control group.3. Testing thesignificance and relevance with SPSS18.0statistical software. Using χ2test toexamine the correlation between the expression of PTEN, PI3K and clinicalpathological factors; usingχ2test to analyze the connect between the expressingsituation of PTEN, PI3K and the toxic side effects too; using Spearman test to analyzethe relationship between the expression of PTEN and PI3K in colon carcinoma；using Kaplan-Meier to analyze the connect between the expression of PTEN, PI3Kand Middle Time to Progression (MTTP), using Log-rank to analyze the difference ofTTP between positive and negative expression of PTEN, PI3K. Take the two-tailedas significance level α=0.05, P <0.05indicates statistical significance.Result:1. The expression of PTEN:(1) There were39cases of PTEN positive expression in42normal colontissues, the positive rate was92.86%; meanwhile, there were23cases ofPTEN positive expression in42colon carcinoma tissues, the positive rateof was54.76%. The difference between the two groups indicatedstatistical significance (χ2=19.055，P=0.04<0.05).(2) The expression of PTEN was not related to sex, age, tumor location andsize (P>0.05), but it was closely associated with the degree ofdifferentiation, lymph node metastasis, distant metastasis and tumor stage. In moderately differentiated group, the positive rate of PTEN was67.86%,and in poorly differentiated group, the positive rate was28.57%, theformer was higher than the latter(χ2=4.667, P=0.031<0.05). In the groupwithout lymph node metastasis, the positive rate of PTEN was73.68%, inthe group with lymph node metastasis, the positive rate was31.93%, theformer was obciously higher than the latter(χ2=5.014, P=0.029<0.05).The positive rate of PTEN in the group without distant metastasis was72.00%, meanwhile, it was29.41%in the group with distant metastasis,the difference between the two groups indicated statistical significance(χ2=1.524, P=0.021<0.05). In the tumor stage of Ⅰ andstage of Ⅱgroup, the positive rate of PTEN was71.43%, however, in the stage of Ⅲand stage of Ⅳ group,the number was46.43%, the latter wassignificantly lower than the former(χ2=4.677, P=0.033<0.05).2. The expression of PI3K:(1) There was4positive expressions of PI3K in42normal colon tissues andthe positive rate was9.52%, at the same time,27positive expressions ofPI3K in42colon carcinoma, the positive rate was64.29%, there was thedifference between the two groups indicated statistical significance(χ2=5.762, P=0.016<0.05).(2) The expression of PI3K was not related to sex, age, tumor location, size,the degree of differentiation, lymph node metastasis, distant metastasisand tumor stage (P>0.05).3. Studying the expression of PTEN and PI3K in42cases colon carcinoma, therewere9cases with positive expression of PTEN and negative expression of PI3K;there were13cases with positive expression of PI3K and negative expression ofPTEN; there were14cases with positive expression of PTEN and PI3K; and therewere6cases with negative expression of PTEN and PI3K. The expression of PTENwas negatively correlated with the expression of PI3K, and the correlation indicatedstatistical significance (r=-0.325, P=0.023<0.05).4. In the42cases of colon carcinoma, the expression of PTEN and PI3K was not associated with the toxic side effects (P>0.05).5. In the42cases colon carcinoma tissue, MTTP of the positive expression ofPTEN was22.17mouths, MTTP of the negative cases was12.25mouths, the formerwas significantly longer than the latter (χ2=21.429, P=0.000<0.05).6. In the42cases of colon carcinoma tissue, MTTP of the positive expression ofPI3K was15.03mouths, MTTP of the negative cases was20.35mouths. There wasnot significantly correlation between the two cases(χ2=2.702, P=0.128>0.05).Conclusion:1.PTEN involves in the occurrence of colon carcinoma, and relates to theinvasion, metastasis and prognosis of colon carcinoma. It could be an importantpredictor of the prognosis of colon carcinoma.2.PI3K involves in the occurrence of colon carcinoma, but it is not related tocolon carcinoma invasion and metastasis. It is meaningless to prognosis of coloncarcinoma.3.The expression of PTEN and PI3K in colon carcinoma was negativecorrelative, indicating that the deletion of PTEN may cause the activation of PI3Kpathway. Both of them are closely related to the incidence of colon carcinoma andguide the individualized treatment.