肺癌中多癌基因异常表达的临床研究

Clinical Study on Oncogene Protein Products c-erbB-2, ras p21 and p53 in Lung Cancer

目的 :通过 76例肺癌切除标本进行免疫组化染色来探索癌相关基因 c- erb B- 2、ras p2 1和 p5 3与肺癌的组织分型和 TNM分期之间的关系。方法 :随机选取 76例肺癌手术切除标本 ,其中鳞癌 35例 ,腺癌 2 2例 ,小细胞癌10例 ,大细胞癌 4例 ,腺鳞癌 5例。TNM 期 8例 , 期 35例 , 期 33例。均按文献方法进行免疫组化染色后按阳性表达率进行统计分析。结果 :c- erb B- 2和 p5 3的总阳性表达率分别为 6 4.5 %及 5 2 .6 % ,且在小细胞癌中分别高达 10 0 %和 90 .0 % ,明显超过 ras p2 1(P<0 .0 1) ,但 ras p2 1在腺癌中的表达率 (72 .3% )高于 c- erb B- 2和 p5 3。同时 ,c- erb B- 2在 TNM 期中 87.9%的表达率也高于 、 期和 ras p2 1、p5 3在 期的表达率 (P<0 .0 5 )。结论 :c-erb B- 2过度表达与预后差 ,恶性度高 ,病程长或晚期肺癌有关联 ;ras p2 1可能参与腺癌的发生 ;p5 3则可能与恶性度高 ,预后差的小细胞癌的发生和转归有关。

Objective:The expression of oncogeneprotein products c erbB 2 ,rasp21 and p53 in 76 cases of lung cancer were studied by immunohistochemical technique.Methods:Seventy six operation specimens of lung cancer tissue including 55 males and 21 females with a median age of 49 years (range 28 71 years). Among these, there were 35 cases of squamous cell carcinoma,22 adenocarcinoma, 10 small cell,4 large cell and 5 adenosquamous cell carcinomas. Eight patients were categorized as stage Ⅰ, 35 stageⅡ and 33 stage Ⅲ.Results:The positive rate of c erbB 2 and p53 expression were 64.5% and 52.6% respectively in 76 cases, and were high 100% and 90% respectively in small cell lung cancer under which instance for which markedly exceeded that of rasp21 (P<0.01).Expression of rasp21 in adenocarcinoma(72.3%) was higher than either of c erbB 2 and p53 (P<0.05). Meanwhile, the expression of c erbB 2 in TNM stage Ⅲ was 87.9% which was higher than those in stage Ⅰand Ⅱ, and those of rasp21, p53 in stage Ⅲ.Conclusion:The results indicate that overexpression of c erbB 2 is associated with poor prognosis, high malignancy, long term or advanced of lung cancer. p53 expression related with the occurrence of adenocarcinoma.P53 expression may be associated with the development of small cell lung cancer.