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治疗靶点在尤文肉瘤家族肿瘤中的表达。

Expression of therapeutic targets in Ewing sarcoma family tumors.

机构信息

Department of Pathology, Children's Mercy Hospital, Kansas City, MO 64108, USA.

出版信息

Hum Pathol. 2012 Jul;43(7):1077-83. doi: 10.1016/j.humpath.2011.09.001. Epub 2011 Dec 21.

Abstract

Ewing sarcoma family tumor is an aggressive malignant tumor of bone and soft tissue in children and adolescents. Despite advances in modern therapy, metastasis occurs in 20% to 25% of cases and results in mortality in 80% of patients. Intracellular molecules mammalian target of rapamycin, Akt, vascular endothelial growth factor, nuclear factor κB, and BRAF are important kinases and transcription factors that regulate the proliferation of tumor cells. We studied the expression of these proteins in 72 Ewing sarcoma family tumors. Patients' survival data were available in 55 cases. Formalin-fixed, paraffin-embedded tumor sections were stained with antibodies against phosphorylated mammalian target of rapamycin, Akt, BRAF, vascular endothelial growth factor, and nuclear factor κB proteins. Stained sections were analyzed for percentage and strength of staining, and a composite score (0-200) was subsequently generated. Although most tumors expressed mammalian target of rapamycin, Akt, nuclear factor κB, and vascular endothelial growth factor, only 37%, 86%, 55%, and 12%, respectively, showed high expression (staining score ≥ 100). There was no significant correlation between mammalian target of rapamycin and Akt expression and clinical outcome. High nuclear factor κB expression was significantly associated with tumors in pelvic locations. Decreased vascular endothelial growth factor expression (score <100) was significantly associated with better prognosis (P < .05). BRAF was not expressed in most cases and showed negative or weak staining (score <100) in 97% of cases. Thus, except for BRAF, Ewing sarcoma family tumors may be amenable to treatment that targets the expressed proteins. High Akt expression suggests potential universal response to Akt-targeted therapy. BRAF kinase inhibitors are unlikely to be effective in the treatment of Ewing sarcoma family tumors.

摘要

尤文肉瘤家族肿瘤是儿童和青少年骨骼和软组织的侵袭性恶性肿瘤。尽管现代治疗取得了进展,但仍有 20%至 25%的病例发生转移,并导致 80%的患者死亡。细胞内分子哺乳动物雷帕霉素靶蛋白、Akt、血管内皮生长因子、核因子 κB 和 BRAF 是调节肿瘤细胞增殖的重要激酶和转录因子。我们研究了 72 例尤文肉瘤家族肿瘤中这些蛋白质的表达。在 55 例病例中可获得患者的生存数据。用针对磷酸化哺乳动物雷帕霉素靶蛋白、Akt、BRAF、血管内皮生长因子和核因子 κB 蛋白的抗体对福尔马林固定、石蜡包埋的肿瘤切片进行染色。对染色切片进行染色百分比和强度分析,随后生成综合评分(0-200)。虽然大多数肿瘤表达哺乳动物雷帕霉素靶蛋白、Akt、核因子 κB 和血管内皮生长因子,但分别只有 37%、86%、55%和 12%表现出高表达(染色评分≥100)。哺乳动物雷帕霉素靶蛋白和 Akt 表达与临床结果之间无显著相关性。高核因子 κB 表达与盆腔部位的肿瘤显著相关。血管内皮生长因子表达降低(评分<100)与更好的预后显著相关(P<0.05)。大多数情况下未检测到 BRAF 的表达,97%的病例显示 BRAF 染色为阴性或弱阳性(评分<100)。因此,除了 BRAF 之外,尤文肉瘤家族肿瘤可能可以通过靶向表达蛋白的治疗方法进行治疗。高 Akt 表达提示对 Akt 靶向治疗可能具有普遍反应。BRAF 激酶抑制剂不太可能对尤文肉瘤家族肿瘤的治疗有效。

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