Ki-67抗原和p53蛋白在胃癌中的表达及其临床意义

Clinical significance of Ki-67 antigen and p53 protein expression in gastric carcinoma

目的研究Ki-67抗原和p53蛋白在胃癌组织中的表达水平及其与胃癌生物学行为和预后的关系。方法应用免疫组化方法检测232例胃癌组织中Ki-67抗原和p53蛋白的表达水平。结果Ki-67抗原和p53蛋白表达之间呈显著正相关(P<0.001)。Ki-67抗原和p53蛋白表达水平与胃癌淋巴结转移均密切相关,而与性别、年龄、肿瘤大小、肿瘤部位、组织类型、浸润深度、远处转移、pTNM分期无关。Ki-67抗原、p53蛋白表达阳性其3年生存率均显著低于表达阴性者(P=0.006,0.007),且Ki-67-/p53-组的胃癌患者3年生存率显著高于其他组(Ki-67-/p53+,Ki-67+/p53-,Ki-67+/p53+)(P=0.011,0.017,0.001)。多因素生存分析显示p53蛋白水平是独立的预后因素(P=0.002)。结论Ki-67抗原和p53蛋白表达与胃癌淋巴结转移及预后有关,p53蛋白水平是独立影响胃癌预后的重要参数;联合检测Ki-67抗原和p53蛋白时,只要任1项阳性即提示不良预后。

Objective To study the expression of Ki-67 antigen and p53 protein in human gastric carcinoma, and the relation of the 2 parameters to biological behavior and prognosis. Methods The expressions of Ki-67 antigen and p53 protein were determined by immunohistochemistry technique in 232 patients with gastric carcinoma. Results The expression intensity of Ki-67 antigen was directly proportional to that of p53 protein （ P 〈 0. 001 ）. The expression levels of Ki-67 antigen and p53 protein were both closely correlated with regional lymph node metastasis, but not with patient＇s sex, age and tumor size, location, histological type, infiltration depth, distant metastasis, nor pTNM stage. The 3-year survival rate of those with positive expression of Ki-67 antigen or p53 protein was higher than those with negative expression （ P = 0. 006 , 0.007 ）. The 3-year survival rate of the group Ki-67 -/p53 - was significantly higher than the other three groups（Ki-67 -/p53 ＋ , Ki-67 ＋/p53 - , Ki-67 ＋/p53 ＋ ） （ P =0.011, 0.017, 0.001）. Multivariate survival＇ analysis confirmed that p53 protein expression was independently associated with the 3-year survival rate （ P = 0.002 ） . Conclusions Ki-67 antigen and p53 protein expression levels were both significantly correlated with regional lymph node metastasis and prognosis. P53 protein expression is an independent indicator of gastric carcinoma prognosis. Combined analysis of Ki-67 antigen and p53 protein expression showed that positive expression of anyone of them suggests a poor prognosis.