大肠癌组织p53、PCNA表达与临床病理及预后的关系

Expression of p53,PCNA in colorectal cancer and its clinopathologicalcorrelation and prognostic significance

目的：探讨突变型ｐ５３ 蛋白、增殖细胞核抗原（ＰＣＮＡ） 在结直肠癌细胞中的表达情况与临床病理及预后的关系。方法：用ＬＳＡＢ 免疫组化方法检测１７２ 例癌组织中的ｐ５３ 蛋白、ＰＣＮＡ 的表达情况，用Ｌｏｇｉｓｔｉｃ 回归分析ｐ５３ 表达的相关因素，Ｃｏｘ 模型分析ｐ５３ 、ＰＣＮＡ 表达对预后的的影响。结果：ｐ５３ 、ＰＣＮＡ 阳性率分别为４３－６ ％ （７５／１７２） 、９１－３ ％ （１５７／１７２） 。ｐ５３ 表达与临床病理因素无关，ｐ５３ 阳性预后比阴性差，ｐ５３ 阳性常伴有ＰＣＮＡ 过度表达，但ＰＣＮＡ 高表达，预后有好的趋势。结论：结直肠癌ｐ５３ 突变的癌细胞多呈高增殖状态，ｐ５３ 阳性、ＰＣＮＡ 中、低强度表达是预后差的生物学指标。ＰＣＮＡ 高表达，是癌细胞处于高增殖状态、对化疗敏感的标志，对该类病人给予辅助化疗可望提高根治术疗效。

Objective:To explore the expression of mutant p53 protein,PCNA in colorectal cancer and its clinopthological correlation and prognostic significance. Methods:p53 protein and PCNA were immunohistochemically studied by LSAB in formalin fixed prarffin embeded specimens of 172 colorctal cancers.Logistic and Cox model were used to analyse the relationship between p53 and PCAN,clinopathological manifestations. Results:p53 and PCNA positive rate were 43 6%(75/172) and 91 3%(157/172),respectively.There was no significant correlation between p53 expression and clinopathological manifestations.p53 positive tumors always coexisted with over expression of PCNA,and its prognosis was worse than tnat of p53 negative tumor.Although no statistic significance of prognosis was found in over expressin of PCNA,strong PCNA would have tendency to better prognosis. Conclusions:p53 positive cells were associated with high growth.Immunoreactivity of p53 with weak PCNA in colorectal cancer would be biologic markers of worse prognosis but strong PCNA would be a biologic marker of cancer cell in high growth status,which susceptible to 5 FU,and adjuvant chemotherapy for the patients would improve the result of radical resection.