非小细胞肺癌组织p53和c-erbB2及MRP蛋白的表达  

Expression of p53,MRP and c-erbB2 in non-small cell lung cancer and its clinicopathological significance

作　　者：徐裕金[1,2] 王连聪[1] 郑晓[2] 刘冠[2] 王跃珍[2] 赖宵晶[2] 李健强[2] 

机构地区：[1]浙江大学医学院附属第二医院肿瘤放疗科,浙江杭州310009 [2]浙江省肿瘤医院肿瘤放疗科,浙江杭州310022

出　　处：《实用肿瘤杂志》2009年第6期553-559,共7页Journal of Practical Oncology

摘　　要：目的探讨癌组织p53、c-erbB2、MRP蛋白表达与非小细胞肺癌(NSCLC)临床病理特征的关系及其预后评估意义。方法应用免疫组织化学方法检测NSCLC患者的肺组织切除标本p53、c-erbB2、MRP蛋白表达,并与其临床病理参数进行比较分析。结果NSCLC组织p53、c-erbB2、MRP蛋白表达阳性率分别为53.9%(82/152)、44.1%(67/152)及43.4%(66/152)。p53表达与性别、细胞分化程度、临床分期、淋巴结转移有显著关系(P<0.05),而c-erbB2与各因素间无统计学差异,肺腺癌MRP蛋白表达阳性率(67.6%)明显高于肺鳞癌(33.0%),有统计学差异(P<0.05)。癌组织p53、c-erbB2、MRP 3种蛋白表达均阳性者的1、2、3年生存率明显低于均阴性者(分别P=0.02、0.01和0.00),p53、c-erbB2、MRP蛋白表达阳性者单纯手术后生存率也明显低于阴性者(P<0.05);p53、c-erbB2、MRP 3种蛋白表达均阴性者预后最好,1-2种阳性者次之,3种均阳性者预后最差(P<0.05)。术后辅助化疗组MRP、c-erbB2蛋白表达阳性者的生存率低于阴性者(P<0.01),但p53蛋白表达阳性与阴性患者的生存率无统计学差异(P=0.82);MRP与c-erbB2表达双阴性者生存率显著高于双阳性者,MRP或c-erbB2单一阳性的生存率介于前两者之间(P=0.01)。多因素Cox分析显示细胞分化程度、c-erbB2是影响NSCLC患者疗效和预后的独立预测因子。结论肿瘤组织p53、c-erbB2、MRP 3种蛋白同时高表达的NSCLC病例预后较差。术后检测p53、c-erbB2、MRP表达对评估可手术NSCLC患者疗效和预后有一定意义。Objective To investigate the expression of p53,c-erbB2 and MRP and its clinicopathological significance in non-small-cell lung cancer （NSCLC）. Methods The expressions of p53,c-erbB2 and MRP protein were detected in 152 tumor samples of primary NSCLC by immunohistochemical staining using a polyclonal antibody. The correlation of protein expression with elinicopathologie parameters was analyzed. Results The positive rates of p53,c-erbB2 and MRP expression were 53.9% （82/152）, 44.1% （67/152） and 43.4% （66/152）, respectively. There was significantly correlation of p53expression with gender ,tumor differentiation ,TNM stage and lymph metastasis （P〈（0.05）,but there was no correlation of cerbB2 expression with clinicopathologic parameters in NSCLCs. MRP positive rate in adenocareinoma was significantly higher than that in squamous-eell carcinomas （67.6% vs 33.0% ,P〈0.05）. Overall survival was significantly correlated with the cooverexpression of pS3,c-erbB2 and MRP proteins. The 1-, 2-, 3-year survival rates in patients with co-positive p53,c-erbB2 and MRP were 72.6% ,54.8% and 32.2% ,respectively,which were lower than those in patients with co-negative expression （92.1%,78.5% and 63.4%; P= 0.02,0.01 and 0. 00）. The survival rate in patients who received surgery alone with copositive expression was lower than that in patients with co-negative expression （P〈0.05） ; and the survival rate of patients who had surgery plus chemotherapy with co-positive c-erhB2 and MRP was lower than that with co-negative （P = 0.01）. Cox＇s model analysis showed that c-erhB2 expression and cell differentiation were independent prognostic factors in patients with completely resected NSCLC. Conclusion p53,c-erbB2 and MRP may be useful indicators in prognosis of NSCLC.

关 键 词：癌 非小细胞肺/病理学 蛋白质P53 基因 ERBB-2 多药耐药相关蛋白质类 免疫组织化学 存活率 预后 

分 类 号：R734.2[医药卫生—肿瘤]