Abstract: Objective To study the expression and clinical significance of vascular endothelial growth factor （VEGF）-A and phosphatidylinositol 3-kinase （PI3K）/protein kinase B （AKT） pathway in colorectal cancer. Methods From September 2013 to September 2015, 80 patients with colorectal cancer were selected, As an observation group, At the same time, the normal intestinal mucosal tissue was cut off as the control group. The VEGF-A, PI3K and AKT expression levels of cancer tissues and adjacent tissues were detected by immunohistochemistry, the positive expression rate was counted and the difference between the two groups was compared. Univariate analysis of the correlation between VEGF-A、PI3K and AKT expression in colorectal cancer and clinicopathological data, Spearman correlation analysis VEGF-A correlation with PI3K and AKT expression. After 5 years, The survival rate of VEGF-A、PI3K and AKT positive and negative expression patients was compared. Results The positive rate of VEGF-A, PI3K and AKT expression in the observation group was significantly higher than that in the control group （P<0.05）. There was no significant correlation between VEGF-A, PI3K and AKT expression levels of colorectal cancer patients and clinical data such as sex, age, tumor diameter, tumor and location （P>0.05）, significantly correlated with TNM stage, differentiation degree, lymph node metastasis and invasion depth （P<0.05）. There was a significant positive correlation between VEGF-A expression and PI3K, AKT expression in colorectal cancer （r=0.625, 0.517; all P<0.05）. The survival rate of colorectal cancer VEGF-A and PI3K and AKT positive expression patients was significantly lower than that of negative group （P<0.05）. Conclusion VEGF-A, PI3K and AKT in colorectal cancer tissues are highly expressed, and showed significant correlation with tumor stage, lymph node metastasis, differentiation and depth of invasion, it also reduces survival, may be involved in the development of colorectal cancer, It is of great significance for clinical diagnosis and treatment.

Key words: VEGF-A, PI3K/AKT pathway, colorectal cancer, expression, clinical significance

摘要： 目的 研究血管内皮生长因子（VEGF）-A及磷脂酰肌醇3激酶（PI3K）/蛋白激酶B（AKT）通路在结直肠癌中的表达及临床意义。方法 选取我院2013年9月到2015年9月间收治的结直肠癌患者80例,作为观察组,同时切取患者癌旁正常肠黏膜组织作为对照组。分别采用免疫组化法检测癌组织和癌旁组织的VEGF-A及PI3K及 AKT表达水平,并分别统计其阳性表达率,比较两组间差异。同时单因素分析结直肠癌组织中VEGF-A、PI3K及AKT表达水平与患者临床病理资料相关性,同时Spearman相关性分析VEGF-A与PI3K及AKT表达相关性。术后随访5年,比较VEGF-A、PI3K及AKT阳性和阴性表达患者生存率。结果 观察组的VEGF-A及PI3K及AKT表达阳性率均明显高于对照组（P<0.05）。结直肠癌患者的VEGF-A及PI3K及AKT表达水平与性别、年龄、肿瘤直径、肿瘤部位等临床资料无明显相关性（P>0.05）,与TNM分期、分化程度、淋巴结转移及浸润深度明显相关（P<0.05）。结直肠癌组织中的VEGF-A表达与PI3K、AKT表达呈正相关（r=0.625, 0.517; 均P<0.05）。结直肠癌VEGF-A及PI3K及AKT阳性表达患者的5年生存率均低于阴性组（P<0.05）。结论 结直肠癌组织中的VEGF-A及PI3K及 AKT均存在高表达现象,且与肿瘤分期、淋巴结转移、分化及浸润深度呈现明显相关性,同时可减少患者生存期,可能参与结直肠癌病情发生发展,对临床诊断及治疗具有重要意义。

关键词: VEGF-A, PI3K/AKT通路, 结直肠癌, 表达, 临床意义