肺癌p53蛋白表达和基因突变与临床病理的相关研究  

p53 alterations in human lung cancer and their correlation with clinicopathological features and prognosis

作　　者：张骏[1] 郑杰[1] 方伟岗[1] 由江峰[1] 钟镐镐[1] 衡万杰[1] 吴秉铨[1] 

机构地区：[1]北京医科大学基础医学院病理学系

出　　处：《中华病理学杂志》1998年第4期286-289,共4页Chinese Journal of Pathology

基　　金：美国中华医学基金

摘　　要：目的检测肺癌中ｐ５３蛋白表达和基因突变状况及其与临床病理和预后的相关性。方法应用免疫组织化学（ＬＳＡＢ法）和聚合酶链反应单链构象多态性分析（ＰＣＲＳＳＣＰ）二种方法。结果检测肺鳞癌４６例、肺腺癌４９例，共９５例。免疫组化ｐ５３蛋白总阳性率为５０５％（４８／９５例），肺鳞癌阳性率为５６５％（２６／４６例）、肺腺癌为４４７％（２２／４９例）。ＰＣＲＳＳＣＰ检测ｐ５３基因突变率为４１１％（３９／９５例），肺鳞癌突变率为４７８％（２２／４６例）、肺腺癌为３４７％（１７／４９例）。突变位于第５外显子者有１５例（３８５％）；６外显子３例（７７％）；７外显子１３例（３３３％）；８外显子８例（２０５％）。两种方法检测的符合率为７７９％（７４／９５例）。Ｎ０（无淋巴结转移）、Ｎ１（第一站，转移到支气管周围或同侧肺门淋巴结）、Ｎ２（第二站，转移到同侧纵隔淋巴结及隆突淋巴结）期肺癌ｐ５３突变率分别为２２６％（７／３１例）、４４２％（１９／４３例）、６１９％（１３／２１例），差异有显著性（Ｐ＜０．０２５）；９５例肺癌中，生存率低于３年组和高于３年组患者的ｐ５３突变率分别为５１９％（２７／５２例）?Objective To investigate p53 protein accumulations and p53 mutations in squamous cell carcinoma and adenocarcinoma of the lung and their correlation with clinicopathological features and prognosis. Methods Immunohistochemistry (LSAB) and nonisotopic PCRSSCP were used to detect p53 abnormalities in lung cancer. Results The general positive rates for immunohistochemistry using antip53 monoclonal antibody Do7 (DAKO) as first antibody was 50.5% in 95 cases of lung cancere, 565% (26/46) in squamous cell carcinoma and 44.9% (22/49) in adenocarcinoma. PCRSSCP results showed that 39 cases (41.1%) showed abnormal bands. The mutation rate in squamous cell carcinoma was 47.8% (22/46) and 34.7% (17/49) in adenocarcinoma. In 15 (38.5%) cases, the mutations were located on exon 5, 3 (7.7%) were on exon 6, 13 (33.3%) on exon 7 and 8 (20.5%) on exon 8, respectively. The concordance rate of immunohistochemistry and PCRSSCP was 77.9% (74/95). The mutation rates of p53 gene in NO, N1, N2 staged lung cancer were 22.6% (7/31), 44.2% (19/43) and 61.9% (13/21), respectively. The difference was statistically significant (P<0.025). The 3 year survival rate in patients with p53 mutations was significantly lower than those without p53 mutations (P<0.025). Conclusion The location of p53 mutations in squamous cell carcinoma and adenocarcinoma of the lung were more commonly seen on exon 5 and exon 7. p53 mutations were associated with increased lymph nodes metastasis and reduced survival rate in squamous cell carcinoma and adenocarcinoma of the lung.

关 键 词：肺肿瘤 P53蛋白 预后 病理 基因突变 

分 类 号：R734.2[医药卫生—肿瘤]