p53蛋白表达与胃窦癌根治术后远期疗效关系

Relationship between Long-term Effect and Expression of p53 Protein in Antral Gastric Cancer after Redical Surgery

[目的]探讨p53蛋白在胃癌细胞的表达及与预后的关系。[方法]应用免疫组化技术检测131例胃窦癌p53蛋白的表达,分析p53蛋白表达与临床病理参数的关系,以及与胃窦癌根治术后远期疗效的关系。[结果]胃癌组织中p53蛋白的阳性表达率为42%(55/131);p53蛋白表达与患者性别、年龄、病程、肿瘤Borrmann分型、组织学类型等临床病理参数无关(P>0.05),但与肿瘤的胃壁浸润深度(T分期)和淋巴结转移(N分期)呈显著正相关(P<0.05)。全组根治术后5、10年生存率分别为53.6%和45.9%,其中p53阴性组的5、10年生存率分别为61.1%和49.7%,中位生存时间为107.8个月;而p53阳性组的5、10年生存率均为42%,中位生存时间为35.3个月,两者比较差异有极显著性(P=0.006)。[结论]p53蛋白表达与胃癌细胞的浸润和淋巴结转移密切相关,是胃癌根治术后预后不良的重要影响因素。

[Purpose]To investigate expression of p53 protein in gastric cancer cells and its relationship with prognosis. [Methods ]Immunohistochemical technique was used to detect expression of p53 protein in 131 cases with antral gastric cancer. The relationship between expression of p53 protein and clinicopathological factors and with long-term effect in antral gastric cancer after radical surgery were analyzed. [Results]The positive rate of p53 protein was 42%（55/131） in gastric cancer tissue. There was no significant correlation of p53 protein expression with gender, age, course of disease, Borrmann and histological type of tumor （P〉0.05）, but a significant positive correlation with tumor invasive depth to wall and metastasis of lymph nodes（P〈0.05）. Overall 5-, and 10-year survival rate after radical surgery were 53.6% and 45.9% respectively. For negative p53 group, 5-, and 10-year survival rate were 61.1% and 49.7% respectively with a median survival of 107.8 months; and for positive p53 protein group, 42% and 42% respectively with a median survival of 35.3 months. There was significant difference between patients with negative and positive p53 protein （P=0.006）. [Conlusion]p53 protein expression has a significant cotTelation with tumor invasion and lymphatic metastasis in gastric cancer, and it is a poor prognostic predictor for gastric cancer after radical surgery.