动态监测肝细胞癌血清p53蛋白的临床意义

DETECTION OF SERUM P53 PROTEIN IN PATIENTS WITH HEPATOCELLULAR CARCINOMA AND ITS SIGNIFICANCE

目的了解血清p53蛋白在肝细胞癌(HCC)诊断、外科手术治疗及随访过程中浓度的变化,分析并探讨血清p53蛋白在HCC发生、发展及复发中的意义。方法采用酶联免疫吸附试验(ELISA)检测61例HCC病人术前、术后7天及随访3个月血清p53蛋白的浓度;以30名健康献血者及21名肝炎后肝硬化(HL)病人为对照;同时用免疫组化分析全部标本石蜡切片p53蛋白的表达。结果HCC病人术前血清p53蛋白浓度高于健康献血者及HL病人,差异有显著性;根治性切除术前血清p53蛋白浓度与非根治性手术间无差异;根治性切除术前、术后7天,随访3个月血清p53蛋白的浓度间均无显著性差异;根治性切除随访3个月复发组较无复发组在术前、术后7天,随访个3月同期之间比较,均明显增高,有显著性差异;血清p53蛋白浓度升高与免疫组化p53蛋白过度表达密切相关。结论血清p53蛋白浓度升高反映p53基因的突变,为HCC形成的早期事件,且与其转移、复发密切相关;p53蛋白可作为HCC一种潜在性血清肿瘤学标志物,评估预后,并指导临床治疗。

Objective To study the change of serum p53 protein concentrations in patients with hepatocellular careioma （HCC） during the diagnosis, postoperative treatment and follow-up, and analyze its significance in HCC occurrence, development and recurrence. Methods Serum p53 protein concentrations were determined by enzyme linked immunosorbent assay （ELISA） in experimental groups and control groups. And the expression of mutation p53 protein was observed in fixed tissue sections with formalin by immunohistochemical staining method. Results Serum p53 protein concentrations of HCC before the operation are significantly higher than those of 30 healthy volunteers and 21 liver cirrhosis （LC） patients with chronic HBV infection, and the concentrations of 38 preoperative serum samples show no significant difference from those of the operative group treated with non-ncurative resection. And the concentrations of the recurrent cases are significant different from those in 38 cases preoperative sersample, 38 cases 7-day postoperative serum sample and 19 cases 3-month postoperative serum. Conclusion The elevation of serum p53 protein concentration is in the earlier stage of HCC occurrence, reflects the mutation of the gene p53 and relates with the HCC transfer and recurrence, p53 protein can be regards as the serum tumor marker, and be applied for evaluating prognosis and guiding the clinical therapy.