胃肠道间质瘤中p53和bcl-2表达与预后的关系

Expression of p53 and bcl-2 in gastrointestinal stromal tumors and their relation to prognosis

目的探讨细胞凋亡相关基因p53和bc l-2在胃肠道间质瘤(gastrointestinal strom al tumors,G ISTs)中的表达与预后关系。方法对194例G ISTs构建组织微阵列(TMA),采用免疫组化EnV ision法检测G ISTs组织中p53和bc l-2基因蛋白的表达。结果在p53 TMA中,184例可评估(94.8%),在bc l-2 TMA中181例可评估(93.3%)。p53和bc l-2基因蛋白阳性率分别为34.8%和59.1%。p53蛋白阳性表达率与肿瘤大小、NIH分级、肿瘤部位、坏死、细胞密集程度、核分裂象和转移复发有关。bc l-2阳性表达率与肿瘤大小、NIH分级、肿瘤部位、坏死和黏膜受累及有关。p53蛋白阳性和阴性表达者的5年生存率分别为40.1%和76.5%,两者比较差异有显著性(P<0.01)。bc l-2阳性和阴性表达者的5年生存率分别为55.1%和76.2%,两者比较差异有显著性(P<0.05)。p53蛋白阳性组和阴性组与bc l-2蛋白的阳性表达差异有显著性(P<0.01)。结论p53、bc l-2表达与G ISTs预后有关,p53、bc l-2可作为判断G ISTs预后的标志物。

Purpose To explore the expression of apoptosis-related gene p53 and bcl-2 in gastrointestinal stromal tumors （GISTs）and their relation to the prognosis. Methods Tissue microarray （TMA）has been constructed in 194 cases of GISTs and EnVision method of immunohistochemistry was used to detect p53 and bcl-2 expression. Results 184 （94. 8% ） cases among p53 TMA blocks were available ,while 181 （93.3%） among bcl-2 TMA were available for analysis. The positive expression rate of p53 and bcl-2 was 34. 8% and 59. 1% respectively. The positive expression of p53 was related to tumor size, NIH grading,primary location of tumor, necrosis, cellularity of tumor cells,mitoses accounts, recurrences and metastases of tumor. The positive expression of bcl-2 was related to tumor size, NIH grading ,primary location of tumor, necrosis and mucosal invasion. The 5-year survival rates of those with or without p53 expression were 40. 1% and 76. 5% respectively. There was significant difference between the two groups （P 〈0. 01 ）. The 5-year survival rates of those with or without bcl-2 expression were 55. 1% and 76. 2% respectively. There was statistical significance difference between positive bcl-2 expression group and negative group （P 〈 0. 01 ）. Conclusions The expression of p53 and bcl-2 is closely related with the prognosis of GISTs and may be considered as a marker for prognosis of GISTs.