p53和p21^(WAF1)在鼻咽癌rAd-p53瘤内注射前后的表达及其与近期预后的关系

Expression of p53 and p21^(WAF1) Protein in Advanced Nasopharyngeal Carcinoma before and after Intratumoral Injection of RAd-p53 and Their Relationships with Short-term Prognosis

目的探讨重组人p53腺病毒(rAd-p53)瘤内注射前后鼻咽癌(NPC)组织中p53蛋白和p21WAF1蛋白的表达情况,及其与鼻咽癌近期疗效的关系。方法应用免疫组织化学法检测12例鼻咽慢性炎组织和63例确诊中晚期鼻咽癌组织的p53和p21WAF1蛋白表达情况。63例中晚期鼻咽癌随机分为2组:p53治疗组(32例):rAd-p53瘤内注射+同步放化疗;常规治疗组(31例):同步放化疗。分析两组治疗前及放疗至20 Gy时p53和p21WAF1蛋白表达情况及其与预后的关系。结果 NPC组织中p53和p21WAF1蛋白阳性表达率分别为49.21%和46.03%,和鼻咽黏膜慢性炎相比差异有统计学意义(P<0.05)。NPC组织中p53和p21WAF1蛋白表达有相关性(rs=0.556,P=0.000)。放疗前及放疗至20 Gy时,鼻咽癌p53治疗组和p21WAF1蛋白阳性表达率差异有统计学意义(P<0.05);两组p53蛋白和p21WAF1蛋白阳性表达与1年无瘤生存率有关(P<0.05)。结论 rAd-p53瘤内注射后p53和p21WAF1蛋白的阳性表达可能在抑制鼻咽癌复发或转移进程中起着重要作用,并预示较好的预后。

Objective To investigate the expression of p53 and p21WAF1 in the NPC cells before and after intratumoral injection of recombinant adenovirus p53（rAd-p53） and their relationships with short-term prognosis.Methods The expression of p53 and p21WAF1 protein were examined by immunochemistry in 12 cases of chronic nasopharynxitis and 63 cases with advanced stage nasopharyngeal carcinoma.Sixty-three cases of NPC were randomly divided into two groups：the p53 therapy group（32 cases） for rAd-p53 intratumoral injection plus radiotherapy and chemotherapy;and the common therapy group（31 cases） for radiotherapy and chemotherapy.The expression levels of p53 and p21WAF1 in biopsy samples from all the cases before and at the 20 Gy of radiotherapy were analyzed;And their relationship with prognosis was also analyzed.Results The expression of p53 and p21WAF1 in 63 cases of NPC was 49.21% and 46.03%,respectively.There was a significant difference between NPC and chronic pharyngitis tissues（P〈0.05）.There was correlation between p53 and p21WAF1 expression in NPC tissues（rs=0.556,P=0.000）.Before radiotherapy and at the 20 Gy of radiotherapy,positive expression of p21WAF1 in the p53 therapy group was significant difference（P〈0.05）;and the positive expression of p53 and p21WAF1 was related to the 1-year disease-free survival rate in both groups（P〈0.05）.Conclusion The positive expressions of p53 and p21WAF1 after rAd-p53 intratumoral injection may play an important role in repressing the recurrence and metastasis of NPC,which indicates a better prognosis.