原发性肝癌患者血清P53蛋白检测的临床意义

Serum P53 protein detection for hepatocellular carcinoma patients

目的评价血清P53蛋白对原发性肝癌(hepatocellular carcinoma,HCC)诊断的临床价值,分析并探讨血清P53蛋白对HCC动态监测及治疗的临床意义。方法采用ELISA检测血清P53蛋白的浓度,同时结合Western blot和免疫组化结果分析130例标本P53蛋白的表达情况,利用受试者工作特征曲线(receiver operating characteristic curve,ROC)比较血清P53蛋白和AFP检测结果。结果ELISA检测显示HCC患者血清P53蛋白浓度显著高于健康体检者及肝硬化患者(P<0.05);血清Western blot结果显示在53×103处可检测到单一的条带,血清P53蛋白浓度升高与Western blot检测的光密度值密切相关。免疫组化检测P53蛋白阳性率为64.62%,血清P53蛋白检测与免疫组化检测结果符合率达84.62%;ROC曲线分析显示血清P53蛋白检测和AFP检测曲线下面积分别为0.910和0.954,二者Kappa=0.657,P=0.000,表明2种方法的检测结果有正相关关系,检测结果吻合。结论血清P53蛋白浓度升高能较好地反映p53基因的突变,对肝癌的临床诊断、治疗和动态监测有一定的临床意义,并可作为HCC手术后动态监测和指导临床治疗的一个的生物学指标。

Objective To evaluate the clinical significance of serum P53 protein level in the diagnosis of hepatocellular carcinoma （HCC）. Methods Serum P53 protein levels were determined by enzyme linked immunosorbent assay （ELISA） for 327 HCC patients, 91 hepatic cirrhosis （HC） patients and 80 healthy subjects. Immunohistochemical staining （IHC） and Western blotting were performed to detect the expression of P53 protein for 130 HCC patients who received biopsy and operation. Receiver operating characteristic curve （ROC） was used to analyze the concordance of serum P53 protein and alpha fetoprotein （AFP） level. Results A significant increase of serum p53 levels was found in HCC patients compared to healthy subjects and HC patients （P 〈0. 05）. A single band of 53 000 was detected in the corresponding sera by Western blot assay. The elevation of serum P53 protein levels was validated by the results of Western blotting. The coincidence rate of the results by ELISA and IHC was 84.62%. The area under curve （AUC） of P53 protein and AFP was 0. 910 and 0. 954, respectively （ Kappa = 0. 657, P = 0. 000 ） , suggesting no significant difference exists between the two methods. Conclusion The elevation of serum P53 protein level reflects the mutation of p53 gene. P53 protein can be regarded as the serum tumor marker and used in the prognosis of HCC and the guidance of clinical therapy.