p27^(kip1)在早期结直肠癌中的表达及其对预后的意义

The expression and prognostic implication of p27~kip1 in patients with stage Ⅰ and Ⅱ colorectal carcinoma

目的研究早期结直肠癌中p27kip1蛋白的表达情况,探讨肿瘤组织中p27kip1的表达差异在早期结直肠癌预后评价中的意义。方法应用免疫组织化学方法检测114例早期结直肠癌组织中p27kip1的表达水平,应用SPSS10．0软件分析p27kip1表达差异与预后的相关性。结果在早期结直肠癌中p27kip1蛋白高表达率为85．1％(97／114);p27kip1表达水平与肿瘤组织学分级、TNM分期显著相关,而与患者年龄、肿瘤部位等无关(P>0．05);p27kip1高表达组病例根治术后五年无瘤生存率明显高于低表达组病例(88．40％vs．52．94％,P<0．01);多因素分析显示p27kip1与肿瘤组织学分级均为早期结直肠癌的独立预后因素。结论p27kip1蛋白高表达在早期结直肠癌中较为常见,其表达水平是早期结直肠癌的独立预后因素之一;p27kip1可以作为评价患者预后的重要参考指标。

Objective To investigate the expression and prognostic significance of p27^kip1 in patients with stage Ⅰ and Ⅱ colorectal carcinoma （CRC）. Methods We retrospectively analyzed the expression of p27^kip1 by immunohistochemistry in paraffin-embedded specimens from 114 consecutive patients operated for stage I and Ⅱ CRC. Statistical analysis was done with SPSS10. 0 package. Results The rate of p27^kip1 over-expression in stage Ⅰ and Ⅱ CRC was 85.1 % （ 97/114 ）. The expression of p27^kip1 was statistically associated with TNM stage and histologic grade, while there was no significant relationship between p27^kip1 expression and patient＇s age, tumor location. The 5-year disease free survival rate of the patients with p27^kip1 over-expression was significantly higher than those with p27^kip1 low-expression（ 88.4% vs. 52. 9% ,P 〈 0. 01 ）. Multivariate analysis found that p27^kip1 and histologic grade were respectively independent predictors of the prognosis of patients with stage Ⅰ and Ⅱ CRC undergoing radical resection （P 〈 0. 01 ） o Conclusions p27^kip1 over-expression is a frequently seen event in stage Ⅰ and Ⅱ CRC and constitutes a reliable independent predictor of prognosis in CRC patients.