阿比特龙对老年前列腺癌病人PI3K/AKT信号通路及肿瘤标志物水平的影响

doi:10.3969/j.issn.1003-9198.2022.09.014

摘要/Abstract

摘要： 目的研究阿比特龙对老年前列腺癌病人磷脂肌醇3-激酶(PI3K)/蛋白激酶B(AKT)信号通路及肿瘤标志物水平的影响。方法纳入2018年6月至2020年6月我院收治的88例老年前列腺癌病人为研究对象,按照随机数表法分为2组,每组各44例,对照组予以泼尼松治疗,观察组在对照组基础上予以醋酸阿比特龙治疗。分析2组治疗后PI3K/AKT信号通路表达情况,比较2组治疗前后血清前列腺特异性抗原(PSA)、癌胚抗原(CEA)、肿瘤细胞角蛋白19片段(CYFRA21-1)及神经元特异性烯醇化酶(NSE)水平,观察2组治疗前后T淋巴细胞亚群分布及炎症因子IL-8、TNF-α水平。所有病人均接受1年随访,观察2组病人1年生存情况。结果观察组治疗后AKT、PI3K表达水平均显著低于对照组(P＜0.05或P＜0.01)。2组治疗后血清PSA、CEA、CYFRA21-1、NSE水平均显著低于治疗前(P＜0.05);观察组治疗后PSA、CEA、CYFRA21-1、NSE水平均显著低于对照组(P＜0.01)。2组治疗后CD4+、CD4+/CD8+水平显著高于治疗前(P＜0.05),IL-8、TNF-α水平显著低于治疗前(P＜0.05);观察组治疗后CD4+、CD4+/CD8+水平显著高于对照组(P＜0.01),IL-8、TNF-α水平显著低于对照组(P＜0.05或P＜0.01)。观察组1年总生存率显著高于对照组(P＜0.05)。结论阿比特龙可有效改善老年前列腺癌病人炎症水平及免疫功能,抑制PI3K、AKT表达,并降低肿瘤标志物水平,对延长病人生存期具有价值。

关键词: 前列腺癌, 阿比特龙, 磷脂肌醇3-激酶, 蛋白激酶B, 肿瘤标志物

Abstract: Objective To study the effects of abiraterone on phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT) signal pathway and the levels of tumor markers in the elderly patients with prostate cancer. Methods A total of 88 elderly patients with prostate cancer treated in our hospital from June 2018 to June 2020 were enrolled in this study. They were randomly divided into two groups, with 44 cases in each group. The control group was treated with prednisone and the observation group was treated with abiraterone acetate on the basis of the control group. The expression of PI3K/AKT signal pathway after treatment was detected, and the levels of serum prostate specific antigen (PSA), carcinoembryonic antigen (CEA), tumor cytokeratin 19 fragment (CYFRA21-1) and neuron specific enolase (NSE) were measured and compared between the two groups before and after treatment. The distribution of T lymphocyte subsets and the inflammatory factor including interleukin-8 (IL-8) and tumor necrosis factor α (TNF-α)were observed before and after treatment. All patients were followed up for 1 year, and the 1-year survival rate of the two groups was compared. Results The expression levels of AKT and PI3K in the observation group were significantly lower than those in the control group (P＜0.05 or P<0.01). The levels of serum PSA, CEA, CYFRA21-1 and NSE in the two groups after treatment were significantly lower than those before treatment (P<0.05), especially in the observation group (P<0.01). The levels of CD4+, CD4+/CD8+ after treatment were significantly higher than those before treatment in both groups (P<0.05), especially in the observation group(P<0.01). The levels of IL-8, TNF-α were significantly lower than those before treatment in both groups, especially in the observation group (P<0.05 or P<0.01). The 1-year overall survival rate in the observation group was significantly higher than that in the control group (P<0.05). Conclusions Abiraterone can effectively improve the inflammatory level and immune function of the elderly patients with prostate cancer, and can inhibit the expression of PI3K and AKT and reduce the levels of tumor markers. It is valuable to prolong the survival time of the patients.

Key words: prostate cancer, abiraterone, phosphoinositide 3-kinase, protein kinase B, tumor marker

中图分类号:

R737.25

王建卫, 王强, 李鼎. 阿比特龙对老年前列腺癌病人PI3K/AKT信号通路及肿瘤标志物水平的影响[J]. 实用老年医学, 2022, 36(9): 924-928.

WANG Jian-wei, WANG Qiang, LI Ding. Effects of abiraterone on PI3K/AKT signaling pathway and tumor markers in elderly patients with prostate cancer[J]. Practical Geriatrics, 2022, 36(9): 924-928.

参考文献

[1] CICERO A F G, ALLKANJARI O, BUSETTO G M, et al. Nutraceutical treatment and prevention of benign prostatic hyperplasia and prostate cancer[J]. Arch Ital Urol Androl, 2019, 91(3):589-592.
[2] 凌晓辉, 陈佳鸿, 陈志云,等. NRCAM-PI3K-AKT信号通路影响miR-505对前列腺癌细胞的增殖抑制作用[J]. 中华腔镜泌尿外科杂志:电子版, 2020, 14(2):145-148.
[3] 王云恩, 武进峰. 去势抵抗性前列腺癌治疗进展[J]. 中国冶金工业医学杂志, 2018, 35(2):144-145.
[4] 张宇, 荆翌峰, 韩邦旻. 转移性去势抵抗性前列腺癌的病理学特征[J]. 中华老年医学杂志, 2018, 37(4):423-426.
[5] 苏先旭, 黄梦君, 高茜, 等. 阿比特龙联合泼尼松治疗未经化疗转移性去势抵抗性前列腺癌患者的有效性和安全性探讨[J]. 临床和实验医学杂志, 2021, 20(16):1749-1752.
[6] 中华医学会泌尿外科学分会前列腺癌联盟. 中国前列腺癌早期诊断专家共识[J]. 中华泌尿外科杂志, 2015, 36(8):561-564.
[7] 中国抗癌协会泌尿肿瘤专业委员会. 中国去势抵抗性前列腺癌诊治专家共识[J]. 中华外科杂志, 2016, 54(7):1133-1136.
[8] 刘亚超, 牛少曦, 王保军, 等. 不同PSA水平的去势抵抗性前列腺癌患者18F-DCFPyL PET/CT显像特征[J]. 中华泌尿外科杂志, 2021, 42(9):675-678.
[9] 杨丁源, 李俊, 邱明星. 醋酸阿比特龙治疗去势抵抗性前列腺癌合并心血管疾病患者的安全性及生活质量评价[J]. 实用医院临床杂志, 2020, 17(3):188-191.
[10] 王硕, 杜鹏, 杨勇. AR-V7表达与去势抵抗性前列腺癌阿比特龙治疗敏感性的相关性研究[J]. 中华泌尿外科杂志, 2020, 41(3):200-204.
[11] 陈力博, 刘志洪, 胡蓉, 等. 调强放疗联合内分泌治疗对局部晚期前列腺癌患者T淋巴细胞亚群及肿瘤标志物的影响研究[J]. 中国全科医学, 2018, 21(1):32-34.
[12] 李彦魁, 杨文涛, 吴茜. 不同病理分期乳腺癌患者免疫功能、肿瘤标志物及炎症因子的变化分析[J]. 海南医学院学报, 2019, 25(7):515-518.
[13] 赵磊,梁朝朝.前列腺癌生物标志物研究新进展[J].中华泌尿外科杂志,2017,38(6):477-480.
[14] 王瑞雪, 李艳芳, 郝崇华, 等. Notch受体表达升高诱导前列腺癌患者CD8 + T细胞功能衰竭[J]. 中华医学杂志, 2020, 100(34):2669-2674.
[15] GUENGERICH F P, MCCARTY K D, CHAPMAN J G, et al. Stepwise binding of inhibitors to human cytochrome P450 17A1 and rapid kinetics of inhibition of androgen biosynthesis[J]. J Biol Chem,2021,297(2):100969.
[16] 董世濠, 陈劲松. 磷脂酰肌醇3-激酶催化亚基δ基因的研究进展[J]. 中华实验外科杂志, 2018, 35(1):193-196.
[17] 耿军辉, 张丽军, 王亚丽, 等. PI3K/Akt信号通路与肿瘤血管新生的研究进展[J]. 现代肿瘤医学, 2018, 26(9):1462-1466.
[18] 王之泽, 张宇聪, 丁北辰, 等. 雄激素受体剪接突变体7和雄激素受体表达量的比值在预测前列腺癌内分泌治疗预后中的作用[J]. 中华泌尿外科杂志, 2018, 39(4):275-280.
[19] 李俊, 杜鸿, 廖勇, 等. 阿比特龙治疗转移性去势抵抗性前列腺癌的有效性和安全性初步评价[J]. 重庆医科大学学报, 2018, 43(4):128-133.