胃癌组织中p53蛋白表达的临床意义

外科理论与实践 2000年第2期第5卷 论著

作者：邵春奎　林言箴　尹浩然　朱正纲　顾琴龙　王瑞年

单位：邵春奎（现在中山医科大学附属三院病理科工作，广州(510630)）；林言箴 朱正纲（上海第二医科大学附属瑞金医院外科）；尹浩然 顾琴龙（上海消化外科研究所）；王瑞年（上海第二医科大学病理教研室(200025)）

关键词：胃癌；p53蛋白；预后

　　摘　要：观察p53蛋白表达能否作为判断胃癌病人的预后指标，为该指标的合理应用提供科学依据。方法：利用免疫组化技术检测171例胃癌切除标本内p53蛋白的表达，分析p53蛋白表达与临床病理及预后之间的关系，探讨p53蛋白表达与传统TNM分期在预测预后中的关系。结果：43.3％的胃癌组织有p53蛋白表达，弥漫型胃癌中的p53蛋白表达率高于肠型胃癌(P＜0.05)；有p53蛋白表达的胃癌组织易于发生淋巴结转移(P＜0.05)；有p53蛋白表达的胃癌病人预后差(P＜0.01)。结论：p53蛋白对推测的胃癌病人淋巴结转移率及判断预后十分有益，将p53蛋白表达与经典的TNM分期结合，使该指标的应用更具科学性。

The Clinical Significance of p53 Expression in Gastric Carcinoma．

shao Chunkui,Lin Yanzhen,Yin Haoran(Department of Surgery，Ruijin Hospital，Shanghai Second Medical University，Shanghai(200025))

　　Abstract：To determine the value of p53 expression as a marker of prognosis of gastric carcinoma and to provide a scientific basis for properly using the parameter．Methods：The expression of p53 was studied immunohistochemically in 171 gastric carcinoma patients using paraffin embedded surgical specimens．The correlation between p53 expression in tumor tissue and selected clinicopathologic variables was analyzed．The relationship between p53 expression and traditional TNM prognostic system was discussed．Results：Expression was detected in 43.3％of the gastric carcinoma specimens．The expression rate was higher in the diffuse type gastric carcinoma(P＜0.05)and p53 positive tumors had a higher propensity for lymph node metastasis(P＜0.05)．p53 expression was a strong parameter of poor prognosis(P＜0.01)．Conclusions：Assessment of p53 expression in gastric carcinoma is helpful to screen patients with a propensity for lymph node metastasis．When it is used in combination with the classical TNM system，a greater accuracy in prognosis prediction could be obtained．

　　Keywords：Gastric carcinoma p53 protein Prognosis参考文献：

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收稿日期：1999-08-02