肝内胆管结石并肝内胆管癌p53蛋白表达的临床意义

Clinical Significance of p53 protein expression in hepatolithiasis associated intrahepatic cholangiocarcinoma

目的研究p53蛋白表达与肝内胆管结石并肝内胆管癌(HLAIHCC)临床TNM分期之间的关系,探讨其在评价HLAIHCC进展中的价值。方法用亲和素-生物素-过氧化物酶复合物(ABC)法免疫组化检测26例HLAIHCC癌组织及癌旁组织中p53蛋白的表达。分析其临床病理学资料,研究在HLAIHCC中p53蛋白阳性与阴性表达与其各项临床病理学指标间的关系。结果 26例HLAIHCC患者的胆管癌标本均为腺癌。p53蛋白表达阳性者有14例,阳性率为53.8%。癌旁组织中未见p53蛋白表达。HLAIHCC组织中p53的表达与患者性别、年龄、Child分级、HBsAg、肿瘤病理分化程度、单发或多发无显著关系(P>0.05),而与TNM分期、生存期有显著关系(P<0.05)。结论 HLAIHCCp53蛋白高表达与癌症的进展有密切关系,可作为评价HLAIHCC预后的一项指标。

Objective To study the correlation of p53 protein expression to the clinical TNM stage of hepatolithiasis associated intrahepatic cholangiocarcinoma（HLAIHCC）and assess the value of p53 protein expression in predictive of progression of the tumor.Methods The avidin-biotin peroxidose complex technique（ABC）immunohistochemistry was used to detect the expression of p53 protein in samples of HLAIHCC tissue from 26 patients.The clinicopathological data of these 26 patients were analyzed.The relationship between the clinicopathological data and expression of p53 protein was determined.Results Pathologically,all of the HLAIHCC were adenocarcinoma.Positive p53 protein expression was found in 14 out of these 26 patients and the neighboring nontumor and cirrhotic tissues were completely negative for p53 protein expression.The expression of p53 protein in HLAIHCC was not correlated with gender,age,Child grade,HBsAg,histological differentiation type and tumor number（P0.05）but significantly correlated to survival time and TNM stage（P0.05）.Conclusions The expression of p53 protein is significantly correlated to TNM stage and survival time of HLAIHCC.Its up-regulated expression is of potential value in judging progression of HLAIHCC,and it can be used as a marker to evaluate the prognosis of HLAIHCC.