细胞周期素E和p53同时表达与早期胃癌临床病理的关系

The coexpression of cyclin E and p53: correlation with clinicopathological features in early gastric cancer

目的 探讨细胞周期素Ｅ和ｐ５３ 的同时表达在早期胃癌进展中的意义。 方法 用免疫组化法检测９７ 例早期胃癌中细胞周期素Ｅ 和ｐ５３ 的表达。 结果 早期胃癌中细胞周期素Ｅ和ｐ５３ 的表达显著相关，二者的同时表达率为１９％ （１８／９７）。同时表达的早期胃癌中，平均肿瘤最长径（２２ ±１３） ｍｍ ，幽门部发生率３０％ （１５／５０），分化型占２６％ （１８／７０），淋巴管浸润率３５％ （１１／３１） ，均显著低于或高于对照组；淋巴结转移率３８％（５／１３） ，静脉管浸润率３９ ％（７／１８），均高于对照组。同时表达的１８ 例中，５ 年生存率仅为６１ ％（１１／１８），而细胞周期素Ｅ 与ｐ５３ 均阴性者５ 年生存率为９０％ （ Ｐ＝０－００４） 。 结论 细胞周期素Ｅ和ｐ５３ 的同时表达很可能参与和促进了早期胃癌的进展，对两者同时表达者应给予更积极的治疗。

Objective To investigate the significance of co expression of cyclin E and p53 in the progression of early gastric cancer. Methods The expression of cyclin E and p53 were examined by immunohistochemical method in 97 patients with early gastric cancer. Results The expression of cyclin E was significantly related with that of p53 and the incidence of co expression of cyclin E and p53 was 18% (18/97) in early gastric cancer.The average diameter of the early gastric cancers with co expression was (22±13) mm, the incidence in antrum was 30% (15/50), the rate of differentiated type was 26% (18/70), the incidence of lymphatic vessel invasion was 35% (11/31), all these parameters were significantly worse than in control groups. As to the carcinomas with co expression, the incidence of lymph node metastasis was 38%(11/31), the rate of venous vessel invasion was 39%(7/18); both of the incidences tended to be higher than in their negative control groups. The 5 year survival rate of patients with co expression was 61%(11/18),vs. 90% in negative cyclin E and p53 controls ( P =0 004). Conclusion The co expression of cyclin E and p53 may promote the progression of early gastric cancer. The patients with co expression should be given more aggressive postoperative treatments.