胃癌中P27^(Kip1)、P53表达与其浸润、转移和预后的关系

The Expression of P27^(Kip1)、p53 in Gastric Carcinoma in Relation to Pathologic Features and Prognosis

目的 :研究胃癌组织中 P2 7Kip1和 P5 3的表达与胃癌浸润、转移和预后的关系。方法 :用免疫组化 (二步法 )检测 10 0例胃癌组织中的 P2 7Kip1 蛋白和 P5 3蛋白的表达。结果 :P2 7Kip1 蛋白阳性表达检测率 4 4 % ;P5 3蛋白阳性表达检测率 4 9%。在胃癌浸润浆膜组、淋巴结转移组和 5年内死亡组中 P2 7Kip1低表达与 P5 3高表达均与相应组比较差异有显著性 (P<0 .0 5 )。单变量生存分析结果显示 P2 7Kip1 高表达组 5年生存率为 70 .5 9% ,显著高于低表达组 5 4 .5 5 %和阴性组 2 6 % ;P5 3高表达组 5年生存率为 19.2 3% ,显著低于低表达组 4 3.75 %和阴性组 5 3.19%。多变量 Cox回归模型分析显示 P2 7Kip1 、P5 3均是判断胃癌独立的预后指标 ,但低 P2 7Kip1 表达对患者预后差的相对危险度 (RR=3.0 6 )显著大于高 P5 3表达对患者预后差的相对危险度 (RR=2 .33)。结论 :P2 7Kip1低表达与 P5 3高表达的癌细胞常更能浸润与转移 ,使患者生存率明显降低。 P2 7Kip1 和 P5 3是判断胃癌预后的独立指标 ,其中 P2 7Kip1

Objective:The study was designed to investigate the expression of P27 Kip1 and p53 in gastric carcinoma in relation to pathologic features and prognosis.Methods:The expression of P27 Kip1 and p53 at protein level were determined by immunohistochemistry assay (two-step method) in 100 patients with gastric carcinoma.Results:The positive rate of P27 Kip1 expression was 44% and the positive rate of p53 expression was 49%. The reduced expression of P27 Kip1 and the increased expression of p53 had statistic significance (P<0.05) in the corresponding groups of tunica serosa invasion and lymph node metastasis and the one the subjects of which died within 5 years. The results of the monovariate analysis revealed that the 5 year survival rate of the increased P27 Kip1 expression group was 70.59%, which is significantly higher than that of the reduced P27 Kip1 expression group (54.55%) and the negative group (26%); the 5-year survival rate of the increased p53 expression group was 19.23%, which is significantly lower than that of the reduced p53 expression group (43.75%) and the negative group (53.19%) . By Cox multivariate analysis, P27 Kip1 expression level was found to be of independent prognostic significance, and the same as p53. But reduced P27 Kip1 protein expression was a stronger independent predictor of reduced survival (RR=3.06) than p53 expression (RR=2.33).Conclusions:The reduced expression of P27 Kip1 and the increased expression of p53 reflected the more frequent invasion and metastasis, which resulted in the reduced survival of patients. As the independent markers of the gastric carcinoma, the reduced expression of P27 Kip1 is more useful in the prognosis of gastric carcinoma.