胃肠道平滑肌肿瘤突变型p53基因产物的表达及其与临床病理的关系  

Flow cytometric quantitation of p53 protein expressionin gastrointestinal smooth muscle tumors:clinico-pathological correlation and prognostic significance

作　　者：蔡建辉[1] 蒋贻康[1] 张玉印[1] 张祥宏[1] 吕贵华[1] 高清泽[1] 左连富[1] 

机构地区：[1]河北医学院附属第二医院外科,河北医学院附属第二医院病理科,河北省肿瘤研究所

出　　处：《中华外科杂志》1994年第8期483-486,共4页Chinese Journal of Surgery

摘　　要：应用细胞免疫荧光染色技术及流式细胞术，对５５例胃肠道平滑肌肿瘤石蜡组织块的ｐ５３表达进行定量分析。结果表明，正常胃肠道平滑肌组织ｐ５３表达均为阴性。１４例平滑肌瘤，仅有２例出现过度表达（１４％）；潜在恶性平滑肌肿瘤１２例，多数为过度表达（７５％）：平滑肌肉瘤２９例中，则有２６例（９０％）出现过度表达（Ｐ＜０．００５）。从平滑肌瘤、潜在恶性平滑肌肿瘤到平滑肌肉瘤Ⅰ、Ⅱ级，ｎ５３表达量显著递增（Ｐ＜０．００５）。ｐ５３表达量随肿瘤细胞分裂相、异形性、密度的增高也有明显增高（Ｐ＜０．００５）。ｐ５３低表达者５年生存率为８５％，而过度表达者为４８．５％。提示，胃肠道平滑肌肿瘤一旦出现ｐ５３过度表达应考虑为恶性；ｐ５３表达可能和平滑肌瘤向平滑肌肉瘤的转化密切相关；ｐ５３表达可作为判断病人预后的一项客观指标。AbstractQuantitative analvsis of p53 protein expressionwas performed on paraffin- embedded tissues from 55smotith muscle tumors of the gastrointestinal tract byusing immunofluorescence and flow cytometry. Nopositive expression was found in normal smooth muscletissues of the gastrointestinal tract. Overexpression ofp53 gene was found in a significantly higher proportionin leiomvosarcomas(90%)and potential malignantsmooth muscle tumors(75%)compared to leiomyoma;(14%)(P<0.005).The ouantitation of p53 expres-sion was found to be progressively enhanced in the se-quence from leiomyoma through potential malignantsmooth muscle tumor to leiomyosarcoma(P<0.005 ). It was also overexpressed when mitotic counts weremore than 1/10HPF or the mild cytologic atypia wasfound(P<0.005).Five vear survival rate was signifi-cantly higher in the patients with p53 lower expressioncompared to the patients with over-expression(P<0.005).These results suggested that p53 overexpres-sion might be associated with the transformation ofleiomvoma into leiomvosarcoma, and could be used asan objective paramater in distinguishing malignantsfrom benigns and predicting prognosis of the patientswith srnooth muscle tumors of the gastrointestinaltract.

关 键 词：胃肠肿瘤 基因 平滑肌瘤 

分 类 号：R735.03[医药卫生—肿瘤]