P53和MDM2在肺癌中的表达

Expression of P53 and mdm2 in Lung Carcinoma

目的:研究p53和mdm2基因在肺癌中的表达,探讨其与肺癌临床特征及预后的关系;方法:采用免疫组化S—P法,检测p53和mdm2基因蛋白在70例肺癌中的表达。结果:70例肺癌中p53阳性率58.6％;mdm2阳性率52.9％:各型之间表达差异均无显著性。p53阳性表达与鳞癌淋巴结转移及分期有关;与腺癌淋巴结转移有关;与小细胞肺癌淋巴结转移及分期有关;13例正常肺组织均未见p53阳性表达。mdm2阳性表达与鳞癌肿瘤大小、分期有关;与腺癌淋巴结转移及分期有关;与小细胞肺癌分期、分级与淋巴结转移无关;13例正常肺组织中3例mdm2弱阳性表达,经统计处理与肿瘤组织表达差异显著。在各型肺癌中,p53与mdm2共同阳性表达者,生存期最短;p53与mdm2共同阴性表达者,生存期最长。采用图像分析仪测定ADA值(面密度×平均光密度)与镜下观察阳性强度对比差异结果一致。结论:在肺癌中p53与mdm2可作为判断预后的指标。p53与mdm2共同阴性表达者,提示有良好的预后。采用图像分析仪测定ADA值使免疫组化由定性研究转化为定量研究,具有推广应用前景。

Objective: To investigate the expression of p53 and mdm2 and determine their relationship with clinicopathological features and prognosis of lung carcinoma. Methods: Immunohistochemical technique( S - P) method was used to study the expression of p53 and mdm2 in 70 cases of lung carcinoma.Results: p53 protein was overexpressed in 41 cases (58.6%). mdm2 was overexpressed in 37 cases(52. 9%). Expression of p53 was associated with clinicopathological factors such as N-factor and stage in Squamous carcinoma. It was also associated with N - factor in adenocarcinoma and also with N - factor、stage in SCLC. Expression of p53 showed no significant difference among the subtypes. Expression of p53 was negative in 13 cases of normal lung tissue. Expression of mdm2 was associated with clinicopathological factors such as T- factor、stage in Squamous carcinoma. It was associated with N -factor as well as stage in adenocarcinoma. Expression of mdm2 was not associated with clinicopathololgical factors in SCLC. It had no significant difference among subtypes. Three of 13 cases normal lung tissue showed weak positive. Statistical analysis revealed significant difference between normal lung tissue and carcinoma.p53/mdm2 - negative patients had a better prognosis;p53/mdm2-positive patients had a worse prognosis. ADA (area density (?) average optical density) detected by image analyzer was in concordace with intensity of the expression of p53 and mdm2.Conclusions: The results suggest evaluation of the p53/mdm2 in lung carcinoma could be used asprognostic indicators. The co- negative expression in p53 and mdm2 in lung carcinoma indicates the well prognosis. Detecting ADA by image analyzer makes the study of Immunohistochemistry turn the qualitative analysis in to quantitative analysis. Thus the image analyzer may be used broadly in the future.