胃癌组织P^（53）基因突变、蛋白产物的表达及与病人预后的关系

Clinical study of the relationship of P^(53) mutation and expression with the prognosis of patients with gastric cancer

采用ＰＣＲ－ＲＦＬＰ法对正常胃粘膜和胃癌组织中Ｐ５３基因第２４８和２４９编码区点突变进行分析，同时采用免疫组化方法对Ｐ５３蛋白的表达进行观察。结果表明，胃癌组织Ｐ５３第２４８编码区点突变率为７．２％，２４９编码区未发现有点突变。胃癌组织Ｐ５３染色阳性率为３６．５％，肿瘤大于５ｃｍ组，有淋巴结转移和浆膜侵犯及Ⅲ、Ⅳ期胃癌组Ｐ５３染色阳性率分别显著高于肿瘤小于５ｃｍ、无淋巴结转移和浆膜侵犯及Ⅰ、Ⅱ期胃癌组（Ｐ＜０．０１）。Ｐ５３染色阳性者５年存活率为２１．１％，染色阴性者为５０．０％，两组５年存活率差别非常显著（Ｐ＜０．０１）。以上提示检测胃癌组织Ｐ５３蛋白有助于判断胃癌患者预后。

The mutation of P53 gene at codons 248 and 249 and its protein product expression were investigated in l04 formalin-fixed,paraffinembedded specimens of gastric canceer with PCR-RFLP analysis and immunohistochemistry.Mutation was found at codon 248 of P53 in 7.2%(5/69)of the gastric specimens but no mutation at codon 249,36.5%(38/l04)of gastric specimens expressed high level of P53 protein showing positive nuclear staining,which was related to the tumor size,serosal invasion,lymph node involvement and the stages of the cancer.The 5-year survival rate of the patients with positive expressed high of P53 was 21.1%and that with negative expression of P53 was 50%(P<0.01).The data suggest that immunostaining of P53 is of great help to the evaluation of the patients with gastric cancer.