P63和P73蛋白在绒毛膜癌患者中的表达及与其临床病理特征和预后的相关性分析

Expressions of P63 and P73 Proteins in Choriocarcinoma and Their Correlations with Clinicopathological Features and Prognosis

目的探讨P63和P73蛋白在绒毛膜癌患者中的表达及与其临床病理特征和预后的相关性。方法回顾性分析我院2005年5月—2013年1月收治的64例绒毛膜癌患者的资料,记录所有患者的年龄、肿瘤情况、P63、P73蛋白水平和预后情况,比较P63和P73蛋白不同表达绒毛膜癌患者上述资料的差异。结果绒毛膜癌组织中P63蛋白阳性率表达高于正常绒毛组织,P73蛋白低于正常绒毛组织(P<0.05)。HCG水平、肿瘤分期和肿瘤坏死程度越高、出现肺转移的绒毛膜癌患者P63蛋白的高表达率和P73蛋白的低表达率更显著(P<0.05)。P63蛋白高表达、P73蛋白低表达的绒毛膜癌患者5年总生存率显著低于P63蛋白低表达、P73蛋白高的表达者(χ2=6.996,P=0.008;χ2=8.109,P=0.004)。不同年龄、HCG水平、术前是否化疗、肿瘤分期、确诊距前次妊娠的间隔时间、预后评分、P63和P73蛋白表达、是否出现肺转移的绒毛膜癌患者5年生存率比较差异性显著(P<0.05)。肿瘤Ⅲ~Ⅳ期、出现肺转移、预后评分超过7分、P63蛋白高表达和P73蛋白低表达均为影响绒毛膜癌患者预后的独立危险因素(P<0.05)。结论P63蛋白和P73蛋白在绒毛膜癌组织中分别以高表达和低表达存在,且P63蛋白的高表达和P73蛋白的低表达联合肿瘤Ⅲ~Ⅳ期、出现肺转移、预后评分超过7分均为影响绒毛膜癌患者预后的独立危险因素,故临床上可将P63和P73蛋白的检测作为评估绒毛膜癌患者的有效指标。

Objective To investigate expressions of P63 and P73 proteins in choriocarcinoma and their correlations with clinicopathological features and prognosis.Methods Clinical data of 64 patients with choriocarcinoma admitted during May 2005 and January 2013 was retrospectively analyzed.Age,tumor status,levels of P63 and P73 proteins and prognosis of all patients were recorded,and differences in the above data among patients with different expressions of P63 and P73 proteins were compared.Results In choriocarcinoma tissues,positive rate of P63 protein was significantly higher,while positive rate of P73 protein was significantly lower than those in normal chorionic tissues(P<0.05).The higher of human chorionic gonadotropin(HCG)level,tumor staging and degree of tumor necrosis,the more significance of high expression of P63 protein and lower expression of P73 protein in choriocarcinoma patients with pulmonary metastasis(P<0.05).The 5-year overall survival rate of choriocarcinoma patients with high expression of P63 protein and low expression of P73 protein was significantly lower than that in patients with low expression of P63 protein and high expression of P73 protein(χ2=6.996,P=0.008;χ2=8.109,P=0.004).There were statistically significant differences in 5-year overall survival rates among choriocarcinoma patients with different ages and HCG levels,whether or not having preoperative chemotherapy,tumor staging,interval time between final diagnosis and the last pregnancy,prognostic score,P63 and P 73 protein expressions and whether or not having pulmonary metastasis(P<0.05).Tumor stageⅢ-Ⅳ,pulmonary metastasis,prognostic score more than 7 points,high expression of P63 protein and low expression of P73 protein were independent risk factors affecting prognosis of choriocarcinoma patients(P<0.05).Conclusion P63 and P73 proteins are respectively high and low expressions in choriocarcinoma tissues,and high expression of P63 protein and low expression of P73 protein combination of tumor stage III-IV,pulmonary metastasis and prognostic score more than 7 points are independent risk factors affecting prognosis of choriocarcinoma patients,and therefore,detection of P63 and P73 proteins may be used as effective indicators for evaluating choriocarcinoma patients.