Department of General Surgery, Chiba University Graduate School of Medicine, Chuo-Ku, Chiba, Japan.
Department of Surgery, Oami Municipal Hospital, Oami-Shirasato-shi, Chiba, Japan.
J Surg Oncol. 2021 Sep;124(4):598-606. doi: 10.1002/jso.26551. Epub 2021 Jun 1.
Phosphorylated mammalian target of rapamycin (p-mTOR) plays a crucial role in the process of cancer progression. Common gene mutations of colorectal cancer lead to the activation of the PI3k/Akt/mTOR pathway. In this study, we determined whether p-mTOR expression in colorectal liver metastases is a predictive marker of prognosis following liver resection.
Eighty-one patients with colorectal liver metastases who had undergone curative resection were evaluated using immunohistochemistry of p-mTOR. Data regarding clinicopathological features and patient survival were analyzed.
The p-mTOR expression in colorectal liver metastases was detected in 55 (67.9%) patients. Patients whose metastases had high p-mTOR expression showed a significantly lower overall survival rate after resection as compared to patients with low p-mTOR expression (p = 0.016), while there was no significant difference in the disease-free survival between the two groups. Repeat resection for recurrence was performed more frequently in patients with p-mTOR positive than others (p = 0.024). Multivariate analysis showed that p-mTOR expression was an independent prognostic factor of overall survival after liver resection (p = 0.019).
mTOR was frequently activated in colorectal liver metastases, and the p-mTOR expression was a biological marker for predicting the overall survival of patients with colorectal liver metastases following liver resection.
磷酸化哺乳动物雷帕霉素靶蛋白(p-mTOR)在癌症进展过程中起着至关重要的作用。结直肠癌的常见基因突变导致 PI3k/Akt/mTOR 通路的激活。在这项研究中,我们确定了结直肠肝转移中 p-mTOR 的表达是否是肝切除术后预后的预测标志物。
使用 p-mTOR 的免疫组织化学法评估了 81 例接受根治性切除术的结直肠肝转移患者。分析了与临床病理特征和患者生存相关的数据。
在 55 例(67.9%)结直肠肝转移患者中检测到 p-mTOR 表达。与 p-mTOR 低表达的患者相比,p-mTOR 高表达的转移患者在切除后总生存率显著降低(p=0.016),而两组之间无病生存率无显著差异。与 p-mTOR 阴性的患者相比,p-mTOR 阳性的患者更频繁地因复发而再次接受切除术(p=0.024)。多变量分析显示,p-mTOR 表达是肝切除术后总生存的独立预后因素(p=0.019)。
mTOR 在结直肠肝转移中经常被激活,p-mTOR 的表达是预测结直肠肝转移患者肝切除术后总体生存率的生物学标志物。