细胞核增殖抗原、p53及表皮生长因子受体在结直肠癌组织的表达及其临床意义

The clinical significance of proliferation cell nuclear antigen, p53 and Epidermal Growth Factor Receptor expression in colorectal cancer

目的探讨结直肠癌组织中细胞核增殖抗原(Ki-67)、p53及表皮生长因子受体(EGFR)表达的临床意义.方法采用免疫组织化学法,观察Ki-67、p53、EGFR在120例结直肠癌组织的表达,应用x2检验、Fisher确切概率法、Spearman秩相关、生存分析等统计学方法,探讨其与临床病理特征及预后的关系.结果 120例结直肠癌Ki-67、p53及EGFR高表达率分别为63.3%、70.0%、3.3%.Ki-67、p53的表达呈正相关(r=0.300,P<0.05).Ki-67在年龄、国际抗癌联盟(UICC)分期上差异有统计学意义(x2=4.125、5.008,P<0.05);p53在淋巴结转移、组织学分级上差异有统计学意义(x2=7.372、10.088,P<0.05).单因素生存分析显示:Ki-67高表达与预后显著相关(x2=14.678,P<0.05).多因素生存分析显示:p53高表达[风险比(HR):0.276,95%可信区间(CI):0.100 ~0.762,P<0.05]和Ki-67高表达(HR:0.303,95% CI:0.121 ~0.758,P<0.05)是结直肠癌预后的独立危险因素,p53和Ki-67高表达组总生存期短于p53或Ki-67高表达组差异有统计学意义(HR:0.318,95% CI:0.148 ~0.683,P<0.05).结论 p53高表达和Ki-67高表达的组合定义了较小的患者组,其预后更差.

Objective To investigate the clinical significance of expression of proliferation cell nuclear antigen (Ki-67), p53 and epidermal growth factor receptor (EGFR) in colorectal cancer. Methods Immunohistochemistry was used to detect Ki-67, p53 and EGFR protein expressions in 120 cases of colorectal cancer, the χ2 test, Fisher’s exact probabilities, Spearman’s rank correlation, survival analysis were used to explore the relationship between the expression and clinicopathological characteristics and prognosis. Results The high expression rates of Ki-67, p53 and EGFR in 120 cases of colorectal cancer were 63.3%, 70.0% and 3.3%, respectively. Expressions of Ki-67 and p53 were positively correlated (r=0.300, P<0.05). Ki-67 showed significant differences in age and UICC stage (χ2=4.125, 5.008, P<0.05). p53 showed significant differences in lymph node metastasis and histological grade (χ2=7.372, 10.088, P<0.05). Single-factor survival analysis showed that Ki-67 expression was significantly correlated with prognosis (χ2=14.678, P<0.05). Multi-factor survival analysis showed that high p53 expression [hazard ratio (HR): 0.276, 95% confidence interval (CI): 0.100-0.762, P<0.05], and high expression of Ki-67 (HR: 0.303, 95%CI: 0.121-0.758, P<0.05) are independent risk factors for colorectal cancer prognosis, the overall survival time of the group with high expression of p53 and ki-67 was shorter than that of the group with high expression of p53 or Ki-67, which was statistically significant (HR: 0.318, 95%CI: 0.148-0.683, P<0.05). Conclusion The combination of high expression of p53 and high expression of Ki-67 defines a smaller group of patients with worse prognosis.