食管梭形细胞癌p53蛋白的表达与临床病理特征及预后分析

The expression of p53 protein and its clinicopathological features and prognosis of esophageal spindle cell carcinoma

目的:探讨在食管梭形细胞癌中p53蛋白表达与临床病理特征及预后的相关性。方法:收集中国医学科学院肿瘤医院2010年5月至2019年5月术前未接受放化疗的食管鳞状细胞癌病例4439例,复阅病理切片,查阅其临床病理资料,对其中的63例食管梭形细胞癌病例进行p53蛋白免疫组织化学染色检测并分析p53蛋白表达与临床病理特征及预后的相关性。结果:食管梭形细胞癌占同期所有食管鳞状细胞癌的1.4%(63/4439),63例梭形细胞癌患者中男性55例,女性8例,男女比例约为7∶1。在食管梭形细胞癌中鳞状细胞癌成分及梭形细胞成分p53蛋白表达一致率为100%,其中均出现p53蛋白野生型表达有14例,无义突变型表达有22例,错义突变型表达有27例。p53蛋白的突变表达率为77.8%(49/63)。生存分析显示p53蛋白突变型表达与总生存期有显著的相关性(P=0.044),p53蛋白突变型表达的患者总生存期较短。结论:食管梭形细胞癌中p53蛋白表达在鳞状细胞癌成分和梭形细胞成分间具有高度的一致性,p53蛋白突变型表达的患者预后较差。

ObjectiveTo evaluate the association of p53 protein expression with clinicopathological features and prognosis in esophageal spindle cell carcinoma.MethodsA total of 4439 esophageal squamous cell carcinoma(ESCC)patients who underwent radical esophagectomy without neoadjuvant therapy between May 2010 and May 2019 were included.The HE slides and clinicopathological parameters were reviewed.Among these,there were 63 cases of esophageal spindle cell carcinoma;p53 protein expression was evaluated by immunohistochemistry(IHC)and its correlation with clinicopathological parameters and patients′outcome was analyzed.ResultsThe 63 esophageal spindle cell carcinoma accounted for 1.4%(63/4439)of all ESCC.Of the 63 patients there were 55 males and 8 females,male to female ratio was 7∶1.The p53 protein mutation expression rate was 77.8%(49/63),including 14 cases with wild-type expression,22 with nonsense mutation expression,and 27 with missense mutation expression.The concordance rate of p53 protein expression between carcinoma components and spindle cell components was 100%.Survival analysis showed that p53 protein mutation expression was significantly correlated with overall survival(OS,P=0.044),patients with p53 protein mutation expression had poorer OS.Conclusionp53 protein expression is highly concordant in the squamous cell carcinoma components and spindle cell components of esophageal spindle cell carcinoma;its mutation expression is associated with poor outcome of the patients.