突变型P53蛋白在肺腺癌中的表达及其临床意义  

Clinical Significance of Mutant P53 Protein Expression in Lung Adenocarcinoma

作　　者：卞春安[1,2] 李忠佑[1] 许有涛[1] 王洁[1] 许林[1] 沈洪兵[3] 

机构地区：[1]南京医科大学附属江苏省肿瘤医院胸外科,江苏省恶性肿瘤分子生物学及转化医学重点实验室,南京210009 [2]南京江北人民医院,南京210048 [3]南京医科大学公共卫生学院,南京210029

出　　处：《中国肺癌杂志》2015年第1期23-28,共6页Chinese Journal of Lung Cancer

基　　金：国家自然科学基金(No.81372321);江苏省恶性肿瘤分子生物学及转化医学重点实验室专项基金(No.BM2013007);江苏省科技厅临床科技重大专项基金(No.BL2012030)资助~~

摘　　要：背景与目的突变型TP53基因不仅丧失了抑癌功能,其编码的突变型P53蛋白还能获得促进细胞增殖、抑制细胞凋亡等功能。目前TP53基因在肺腺癌中突变的临床意义尚不十分明确。本研究旨在探讨突变型P53蛋白在肺腺癌组织中的表达及其临床意义。方法回顾性分析120例肺腺癌手术患者的临床病理资料,应用免疫组化法检测患者组织标本中突变型P53蛋白的表达,采用χ2检验分析突变型P53蛋白表达与各临床病理参数的关系,采用单因素生存分析及多因素生存分析法分析突变型P53蛋白表达与总生存期的关系。结果突变型P53蛋白在肺腺癌组织中的表达率为63.7%,突变型P53蛋白的表达与肿瘤大小(P=0.041)及病理分期(P=0.025)有关。单因素生存分析提示肿瘤大小(P=0.031)、淋巴结转移(P<0.001)、病理分期(P<0.001)以及突变型P53蛋白的表达(P=0.038)与患者总生存期密切相关。多因素生存分析提示仅有淋巴结转移(P=0.014)是患者总生存期的独立影响因素。结论TP53基因突变的肺腺癌患者预后较差,突变型P53蛋白可以作为预测患者预后的分子标志物。Background and objective P53 is a tumor protein that acts as a tumor suppressor. The mutation of P53 may cause loss of tumor suppressor functions and gain of functions favoring cellular proliferation and apoptosis inhibition. The clinical implications of the tumor protein P53 gene （TP53） mutation in lung adenocarcinoma are indefinite. The aim of this study is to explore the clinical significance of the mutant P53 protein expression in lung adenocarcinoma tissues. Methods The clinicopathological data of 120 lung adenocarcinoma patients who underwent surgery were retrospectively analyzed. The mu- tant P53 protein expression was detected using the immunohistochemical method. Furthermore, the relationship between the mutant P53 expression and the clinicopathological parameters was analyzed using the Chi-square test, whereas that between the mutant P53 expression and overall survival was estimated using the Kaplan-Meier method and Cox regression model. Re- suits The mutant PS3 protein expression rate was 63.3%. Accordingly, the mutant P53 expression was significantly associated with tumor size （P=0.041） and clinicopathological stage （P=0.025）. On the one hand, a univariate survival analysis showed that tumor size （P=0.031）, lymph node metastasis （P〈0.001）, clinicopathological stage （P〈0.001）, and mutant P53 expression （P=0.038） were associated with overall survival. On the other hand, a multivariate survival analysis showed that lymph node metastasis （P=0.014） was an independent poor prognostic factor for overall survival. Conclusion Patients with lung adeno- carcinoma with mutant TPS3 had a poor outcome. Accordingly, the mutant PS3 protein may serve as a molecular prognosis marker for lung adenocarcinoma patients.

关 键 词：TP53基因 突变 肺肿瘤 预后 

分 类 号：R734.2[医药卫生—肿瘤]