表浅性膀胱癌术后复发和生存率与p53和K-ras基因突变的关系  

Relationship of K-ras and p53 gene mutation and superficial bladder cancer postoperative recurrence and survival rate

作　　者：杨森[1] 南存金[1] 木海琦[1] 王怡君[1] 陈映鹤[1] 

机构地区：[1]温州医学院附属第二医院泌尿外科,325027

出　　处：《中华实验外科杂志》2013年第12期2511-2513,共3页Chinese Journal of Experimental Surgery

摘　　要：目的 探讨p53和K-ras基因突变与表浅性膀胱癌术后复发和生存率的关系.方法 选取表浅性膀胱癌切除术的137例患者,并选取29例正常膀胱黏膜组织作为对照,分别提取组织的DNA,采用聚合酶链反应-单链构象多态性分析（PCR-SSCP）和直接测序法分别分析p53和K-ras基因突变,并探讨p53和K-ras突变与表浅性膀胱癌术后复发及生存率的关系.结果 p53突变主要集中于外显子7和8,K-ras集中于外显子1和2.正常膀胱黏膜组织中p53和K-ras基因单突变率分别为3.45％（1/29）和6.90％ （2/29）,p53和K-ras基因双突变率为0％ （0/29）.膀胱癌组织中p53和K-ras单突变的发生率分别为43.07％ （59/137）和30.66％ （42/137）,p53和K-ras双突变的发生率为26.28％（36/137）.膀胱癌组织中p53和K-ras突变的发生率明显高于正常膀胱黏膜的发生率,差异有统计学意义（P＜0.05）.p53和K-ras双突变的术后复发率（75.00％）明显高于p53和K-ras单突变术后复发率（30.51％和28.57％）,差异有统计学意义（P＜0.05）.p53和K-ras双突变的3年生存率明显低于p53和K-ras单突变的3年生存率,差异有统计学意义（P＜0.05）.结论 p53和K-ras突变可能是导致膀胱癌术后复发和生存率较低的原因之一.Objective To explore the relationship of K-ras and p53 gene mutation and superficial bladder cancer postoperative recurrence and survival rate.Methods 137 bladder cancer patients subject to surgery were selected from December 2007 to June 2012.Twenty-nine normal tissue samples were selected as controls.Total DNA was extracted form bladder cancer tissues and normal tissues.p53 and K-ras gene mutations were analyzed by PCR-SSCP and gene sequencing.The relationship between p53 and K-ras gene mutation and superficial bladder cancer postoperative recurrence and survival rate was analyzed.Results p53 gene mutation was found in exons 7 and 8,and K-ras gene mutation in exons 1 and 2.p53 and K-ras gene single mutation rate in normal tissues was 3.45％ and 6.90％ respectively.The double mutation rate of p53 and K-ras gene in normal tissues was 0.The mutation rate of p53 and K-ras in bladder cancer tissues was 43.07％ （59/137） and 30.66％ （42/137） respectively.The double mutation rate of p53 and K-ras in bladder cancer tissues was 32.14％.The double mutation rate of p53 and K-ras in bladder cancer tissue was significantly higher than that in normal tissue （P ＜ 0.05）.Postoperative recurrence in double mutation of p53 and K-ras was significantly higher than that in single mutation of p53 and K-ras （P ＜ 0.05）.The 3-year survival rate in double mutation of p53 and K-ras was significantly higher than that in single mutation of p53 and K-ras （P ＜ 0.05）.Conclusion p53 and K-ras gene mutation is one of the reasons leading to high postoperative recurrence and lower survival rate.p53 and K-ras gene mutation can be used as a clinical prognostic indicators.

关 键 词：膀胱癌 术后复发 P53 K-RAS 基因突变 

分 类 号：R737.14[医药卫生—肿瘤]