Fang Wen-Liang, Huang Kuo-Hung, Lan Yuan-Tzu, Lin Chien-Hsing, Chang Shih-Ching, Chen Ming-Huang, Chao Yee, Lin Wen-Chang, Lo Su-Shun, Li Anna Fen-Yau, Wu Chew-Wun, Chiou Shih-Hwa, Shyr Yi-Ming
Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei City, Taiwan.
School of Medicine, National Yang-Ming University, Taipei City, Taiwan.
Oncotarget. 2016 Feb 2;7(5):6201-20. doi: 10.18632/oncotarget.6641.
Mutations in genes involved in the PI3K/AKT pathway and amplifications of the PIK3CA gene in gastric cancer and their associations with clinicopathological characteristics and EBV infection were analyzed in this study. A total of 431 patients with gastric adenocarcinomas were enrolled, and 39 mutation hotspots were evaluated in these patients using MALDI-TOF mass spectrometry were analyzed. PIK3CA amplifications were analyzed using real-time quantitative PCR. Regarding patients with intestinal-type gastric cancer, those with mutations in PI3K/AKT pathway genes were also more likely to have tumors located in the lower-third of the stomach than were those without mutations. Regarding patients with diffuse-type gastric cancer, those with PI3K/AKT pathway mutations were more likely to have tumors located in the upper-third of the stomach and to have more hematogenous metastases, particularly in the liver and lungs, than were patients without such mutations (22.2% vs. 4.5%). No significant survival difference was observed between patients with vs. without PI3K/AKT pathway mutations. Mutations in PI3K/AKT pathway genes were associated with hematogenous metastasis in patients with diffuse-type gastric cancer. Only when the tumors were located in the middle-third of stomach, tumor with mutations of the PIK3CA gene or mutations of the PI3K/AKT pathway genes were associated with more EBV infection than those without mutations. Patients with PIK3CA amplifications were more likely to have diffuse-type and poorly differentiated gastric cancers and were more likely to experience peritoneal recurrence compared with those without PIK3CA amplifications. Even upon subgroup analysis, PI3KCA amplifications were found to not affect the patients' outcomes.
本研究分析了胃癌中PI3K/AKT通路相关基因的突变、PIK3CA基因的扩增及其与临床病理特征和EBV感染的关系。共纳入431例胃腺癌患者,采用基质辅助激光解吸电离飞行时间质谱分析这些患者的39个突变热点。使用实时定量PCR分析PIK3CA扩增情况。对于肠型胃癌患者,PI3K/AKT通路基因突变的患者比未发生突变的患者更有可能出现位于胃下三分之一的肿瘤。对于弥漫型胃癌患者,与未发生PI3K/AKT通路突变的患者相比,发生PI3K/AKT通路突变的患者更有可能出现位于胃上三分之一的肿瘤,并且更容易发生血行转移,尤其是肝转移和肺转移(22.2%对4.5%)。PI3K/AKT通路突变的患者与未发生突变的患者之间未观察到显著的生存差异。PI3K/AKT通路基因突变与弥漫型胃癌患者的血行转移有关。仅当肿瘤位于胃中三分之一时,PIK3CA基因发生突变或PI3K/AKT通路基因发生突变的肿瘤比未发生突变的肿瘤更容易发生EBV感染。与未发生PIK3CA扩增的患者相比,发生PIK3CA扩增的患者更有可能患弥漫型和低分化胃癌,并且更有可能发生腹膜复发。即使进行亚组分析,也发现PI3KCA扩增不影响患者的预后。