Abstract: 【Abstract 】 Objective To explore the predictive value of phosphatidylinositol 3-kinase/protein kinaseB (PI3K/AKT) signaling axis key factors on the therapeutic e?ect of Ranibizumab in threshold retinopathy of prematurity (ROP). Method A retrospective study was conducted. 154 preterm infants with threshold ROP admitted to the Department oOphthalmology, Xingtai People's Hospital from June 2020 to August 2023 were selected as the case group, and 100 preterm infants with other diseases but no ROP during the same period were selected as the control group. The Western blotting method was used to detect and compare the relative expression levels of PI3K and AKT proteins in peripheral blood mononuclear cell (PBMC). Based on the treatment efficacy, the patients were divided into the e?ective group (n=133) and ine?ective group (n=21), Univariate and multivariate Logistic regression analyses were used to evaluate the in?uencing factors of the therapeutic e?ect of Ranibizumab on threshold ROP. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of PI3K and AKT relative expression in PBMC for threshold ROP and the therapeutic e?ect of Ranibizumab. Spearman method was used to analyze the correlation between key factors of the PI3K/AKT signaling axis and the therapeutic e?ect of Ranibizumab on threshold ROP. Result The relative expression levels of PI3K and AKT proteins in PBMC of the case group were higher than those of the control group (PI3K: 1.63 ±0.39vs 0.56±0.12; AKT: 1.47±0.35vs 0.68±0.16), and the di?erences were statistically signi?cant (all P<0.001). For the prediction of threshold ROP using combined PI3K and AKT in PBMC, the area under the curve (AUC) was 0.859 (95% CI: 0.805-0.912), with a sensitivity of 81.00%, and a speci?city of 84.00%, indicating that the combined detection exhibited the optimal diagnostic value. In the ine?ective treatment group, the proportion of fundus hemorrhage before treatment and the relative expression of PI3K and AKT proteins were signi?cantly higher than those in the e?ective treatment group, while the birth weight was lower than that in the e?ective treatment group, the di?erences were statistically signi?cant (all P<0.05). Fundus hemorrhage before treatment, low birth weight, high PI3K and AKT expression levels were identi?ed as the risk factors for poor response to Ranibizumab treatment for threshold ROP (all P<0.05). The results of ROC curve analysis showed that when the cut-o? values were set at PI3K>1.76 and AKT>1.53, the AUC of the combined detection of these two indicators for predicting the efficacy of Ranibizumab in treating threshold ROP was 0.909 (95% CI: 0.838-0.979), with a sensitivity of 80.95%, and a speci?city of 86.47%. Additionally, the relative expression levels of PI3K and AKT proteins in PBMC were negatively correlated with the therapeutic e?ect of Ranibizumab for threshold ROP (r values were -0.431, -0.446 respectively, all P<0.001). Conclusion High expression of PI3K/AKT signaling axis key factors is signi?cantly associated with poor therapeutic e?ect of Ranibizumab on threshold ROP. The combined detection of PI3K and AKT in PBMC has high clinical value in predicting the therapeutic e?ect.
谢静 王秀先 左相荣 贾玉红 王丽芳. PI3K/AKT 信号轴关键因子对阈值期早产儿视网膜病变雷珠单抗治疗效果的预测价值[J]. 发育医学电子杂志, 2025, 13(6): 462-468.
Xie Jing, Wang Xiuxian, Zuo Xiangrong, et al. Predictive value of PI3K/AKT signaling axis key factors on the therapeutic effect ofRanibizumab in threshold retinopathy of prematurity. Journal of Developmental Medicine(Electronic Version), 2025, 13(6): 462-468.
2025, Vol. 13 
