Ki-67抗原和P53蛋白在胃黏液腺癌组织中的表达及预后分析  

Expression and prognostic significance of Ki-67 antigen and P53 protein in gastric mucinous adenocarcinoma

作　　者：王颖[1] 刘申香 童建东[1] WANG Ying;LIU Shenxiang;TONG Jiandong(Department of Oncology,Affiliated Hospital of Yangzhou University,Yangzhou 225001,China)

机构地区：[1]扬州大学附属医院肿瘤科,江苏扬州225001

出　　处：《现代医学》2020年第11期1413-1419,共7页Modern Medical Journal

摘　　要：目的:探究Ki-67抗原和P53蛋白在胃黏液腺癌组织中的表达及预后意义。方法:回顾性分析扬州大学附属医院2010年至2014年41例胃黏液腺癌病例,采用免疫组化方法检测41例胃黏液腺癌组织中Ki-67抗原和P53蛋白的表达,并分析其表达水平与临床病理特征及预后的关系。结果:P53蛋白和Ki-67抗原在胃黏液腺癌组织中的阳性表达率分别为58.50%和46.30%。Ki-67抗原表达水平与胃黏液腺癌浸润深度和淋巴结转移密切相关(P<0.05)。P53蛋白表达水平与胃黏液腺癌浸润深度、淋巴结转移及TNM分期密切相关(P<0.05)。生存分析表明P53蛋白阳性表达及Ki-67抗原阳性表达均与较差的术后3年生存时间显著相关(P53蛋白:P=0.025;Ki-67抗原阳性:P=0.023)。此外,P53蛋白及Ki-67抗原均阳性表达的患者较两者均阴性表达的患者有着更短的术后3年生存时间(P=0.002)。单因素和多因素分析表明P53蛋白表达水平、Ki-67抗原表达水平、患者年龄、肿瘤分化程度均是影响胃黏液腺癌术后生存时间的独立预后因素(P<0.05)。结论:P53蛋白和Ki-67抗原表达水平与胃黏液腺癌病程进展及预后显著相关,联合检测两者表达水平有望成为该疾病临床预后精准分型的新策略。Objective: To investigate the expression and prognostic significance of Ki-67 and P53 in gastric mucinous adenocarcinoma. Methods: A retrospective cohort of 41 gastric mucinous adenocarcinoma cases from 2010 to 2014 were analyzed in Affiliated Hospital of Yangzhou University. The immunohistochemistry was used to detect the expression of Ki-67 and P53 in 41 cases of gastric mucinous adenocarcinoma tissues. The correlations of their expression with clinicopathological features and patient prognosis were analyzed. Results: The positive expression of P53 and Ki-67 were detected in 58. 50% and 46. 30% of mucinous adenocarcinoma tissues respectively. The expression of Ki-67 was significantly correlated with invasion and lymph node metastasis,while the expression of P53 was significantly correlated with invasion,the lymph node metastasis and TNM staging in gastric mucinous adenocarcinoma( P<0. 05). The survival analysis revealed the positive expression of P53 and Ki-67 was both significantly correlated with shorter three-year survival after surgery( P = 0. 025 for P53 and P = 0. 023 for Ki-67). Moreover,patients with simultaneous positive P53 and Ki-67 expression had a significantly worse three-year survival than those with simultaneous negative P53 and Ki-67 expression( P = 0. 002). The univariate and multivariate analysis showed P53 expression,Ki-67 expression,age and tumor differentiation were independent prognostic factors for postoperative survival of gastric mucinous carcinoma( P<0. 05). Conclusion: Both the expression of P53 and Ki-67 were significantly correlated with the development and prognosis of gastric mucinous adenocarcinoma. Combined detection for their expression may be a novel strategy for precise prognostic stratification in patients with gastric mucinous adenocarcinoma.

关 键 词：胃黏液腺癌 KI-67抗原 P53蛋白 免疫组织化学 预后 

分 类 号：R735.2[医药卫生—肿瘤]