EGFR19/21基因突变与NSCLC组织中p53蛋白表达的关系及对预后的影响

The relationship between EGFR19/21 gene mutation and the expression of p53 in patients with NSCLC and the effect on prognosis

目的探讨表皮生长因子受体19/21(EGFR19/21)基因突变与非小细胞肺癌(NSCLC)患者肿瘤组织中p53蛋白表达的关系及对患者预后的影响。方法收集98例NSCLC患者的NSCLC组织标本,采用TaqmanARMS法检测肿瘤组织中EGFR19/21基因的突变情况,采用免疫组化检测p53蛋白的表达情况,并根据EGFR19/21基因检测结果将患者分为突变组(n=44)和野生型组(n=54),分析EGFR19/21基因突变与p53蛋白表达及患者预后的关系。结果 EGFR19/21基因突变组NSCLC患者p53蛋白的阳性表达率为38.64%,低于野生型组NSCLC患者的59.26%,差异有统计学意义(P﹤0.05)。不同年龄、性别、肿瘤直径、TNM分期、淋巴结转移情况、分化程度、病理类型、ECOG评分NSCLC患者的EGFR19/21基因突变发生率比较,差异均无统计学意义(P﹥0.05);Cox比例风险回归分析结果显示,TNM分期高、发生淋巴结转移、分化程度为低分化、p53蛋白阳性表达是影响NSCLC患者预后的独立危险因素(P﹤0.05),EGFR19/21突变是影响NSCLC患者预后的保护因素(P﹤0.05)。结论EGFR19/21基因突变的NSCLC患者,其p53蛋白呈现低表达,EGFR19/21野生型患者的预后较突变型差。

Objective To investigate the relationship between the mutation of epidermal growth factor receptor 19/21（EGFR19/21） gene and the expression of p53 protein, and the effect on prognosis of non-small cell lung cancer（NSCLC）patients. Method The cancer tissue specimens of 98 patients with NSCLC were collected. The mutations of EGFR19/21 gene in tumor tissue specimens were detected by Taqman-ARMS and the expressions of p53 protein were detected by immunohistochemistry. According to the results of EGFR19/21 gene detection, the patients were divided into mutation group（n=44） and wild-type group（n=54）. The relationship between the mutation of EGFR19/21 gene and the expression of p53 protein, and prognosis of patients were analyzed. Result The positive expression rate of p53 protein of NSCLC patients with EGFR19/21 gene mutation was 38.64%, which was lower than that of NSCLC patients in the wild-type group（59.26%）, and the difference was statistically significant（P〈0.05）. There was no significant difference in the incidence of EGFR19/21 mutation between patients with different ages, genders, tumor diameters, TNM stages, lymph node metastasis, differentiated degree, pathological types, and ECOG scores of NSCLC（P〈0.05）. Cox proportional hazards regression analysis showed that high TNM staging, lymph node metastasis, low differentiated degrees, and positive expression of p53 protein were independent risk factors of prognosis for NSCLC patients（P〈0.05）. EGFR19/21 mutation was a protective factor of prognosis for NSCLC patients（P〈0.05）. Conclusion Patients with EGFR19/21 mutation show lower expression of p53 protein, and the prognosis of patients with wild-type EGFR19/21 is worse than that of patients with mutations.