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作 者:孙威[1] 王强[1] 王明德[1] 秦晔[2] 于文泉 丁安利
机构地区:[1]中国医科大学第二临床学院外科,沈阳110003 [2]辽宁中医学院外科 [3]北票矿务局医院外科 [4]宽甸县人民医院外科
出 处:《中华普通外科杂志》2000年第4期201-203,共3页Chinese Journal of General Surgery
基 金:辽宁省自然科学基金!资助项目 ( 972 2 5 4)
摘 要:目的 探讨抑癌基因p16表达与胃肠道平滑肌肿瘤 (gastrointestinalsmoothmuscletumors,GISMT)良恶性、恶性程度、转移及预后的关系。方法 采用免疫组织化学S P法检测了 86例GISMT患者中抑癌基因p16的表达情况。结果 p16表达率的差异采用 χ2 检验。患者生存率分析采用Ka plan Meier法及Log rank检验。p16的表达率按平滑肌瘤、平滑肌肉瘤Ⅰ、Ⅱ、Ⅲ级依次明显下降(10 0 % ,77% ,45 % ,7% ,P <0 0 1)。同时 ,p16的表达与肿瘤的良恶性生长方式、肿瘤大小、中心有无坏死亦有明显的关系 (P <0 0 1)。本组 86例GISMT中 ,除 3例外 ,其余均随访成功 ,随访时间为 12~2 42个月 ,平均 5 8个月 ,随访率为 96 %。p16阳性表达组的 5年生存率 (70 % )明显高于低表达组(36 % ) (P <0 0 5 )。结论 p16是反映GISMT生物学特性的良好标志物 ,可以作为判断GISMT良恶性、恶性程度、转移及预后的客观指标。Objective[WT5”BZ] In order to determine the relationship between p16 expression and malignancy,metastasis,prognosis of gastrointestinal smooth muscle tumors(GISMT).[WT5”HZ]Methods[WT5”BZ] We studied samples of 86 cases of GISMT by the immunohistochemical staining S P method for p16.[WT5”HZ]Results[WT5”BZ] χ 2 test was used to analyse the difference in the rate of p16 expression.The survival rate of the patients was analysed by Kaplan Meier method and Log rank test.The rate of p16 expression decreased significantly in the following order: Leiomyomas,grade Ⅰ leiomyosarcomas,grade Ⅱ leiomyosarcomas,grade Ⅲ leiomyosarcomas(100%,77%,45%,7%, P <0 01).Meantime the expression of p16 was associated with the tumors with or without contiguous organ invasion or distant metastasis,the size of tumors,the tumors with central necrosis( P <0 01).All but 3 (96%) patients of GISMT in this group were followed up,the follow up period ranged from 12 to 242 months (median 58 months).The five year survival rate was significantly higher in patients with p16 positive expression (70%) than those with p16 negative expression(36%)( P <0 05).[WT5”HZ]Conclusions[WT5”BZ] p16 was the valuable indicator of biological characteristics of GISMT,and could be used as an objective parameter in distinguishing malignant tumors from benign,judging the malignant degree and predicting the prognosis of the patients with GISMT. [WT5”HZ]
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