Effect of neoadjuvant chemotherapy combined with transurethral resection of bladder tumor on PI3K/Akt signaling pathway in patients with bladder cancer

CUI Shengtong; LYU Jianyang

doi:10.13431/j.cnki.immunol.j.20250090

Abstract：Objective To investigate the impact of neoadjuvant chemotherapy combined with transurethral resection of bladder tumor(TURBT)on the phosphatidylinositol-3-kinase(PI3K)/protein kinase B(Akt)signaling pathway in patients with bladder cancer.Methods A total of 118 patients with bladder cancer who were admitted from February 2022 to February 2025 were selected as the research subjects.According to different treatment methods,they were divided into the control group(n=76)for TURBT treatment and the observation group(n=42)for neoadjuvant chemotherapy combined with TURBT treatment.The perioperative indicators,clinical efficacy and adverse reactions of the two groups were compared,and the mRNA expression levels of tumor markers,inflammatory factors and PI3K/Akt signaling pathway indicators before and after treatment were also compared,to analyze the correlation between inflammatory factors and indicators of the PI3K/Akt signaling pathway.Results Both total effective rate and disease control rate of the observation group were higher than those of the control group,and the incidence of adverse reactions was lower than that of the control group(P<0.05).The duration of operation,length of hospital stay and duration of gross hematuria in the observation group were all lower than those in the control group(P<0.05).After treatment in the observation group,carcinoembryonic antigen,carbohydrate antigen 125,carbohydrate antigen 19-9,cytokeratin protein 19 fragment antigen 21-1,interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α),C reactive protein(CRP),prostaglandin E2(PGE2),and the expression levels of B-cell lymphoma-2(Bcl-2),PI3K and Akt mRNA were all lower than those in the control group,while the expression levels of Caspase-3 and Bcl-2 associated X protein(Bax)mRNA were significantly higher than those in the control group(P<0.05).The levels of IL-6,IL-10,TNF-α,CRP and PGE2 in patients with bladder cancer after treatment had stable positive correlations with the expression levels of Bcl-2,PI3K and Akt mRNA,respectively(P<0.05),and a stable negative correlation with the expression levels of Caspase-3 and Bax mRNA(P<0.05).Conclusion Neoadjuvant chemotherapy can attenuate the proliferation of bladder cancer cells by inhibiting the abnormal activation of the PI3K/Akt signaling pathway,while TURBT can eliminate residual tumor tissue and reduce the risk of recurrence.The combined application of the two can achieve effective control at the molecular level,improving the survival rate and quality of life of patients.