P53、P16及Ki-67与早期食管癌患者ESD术后复发的关系分析  

Analysis of the relationship between P53,P16 and Ki⁃67 and recurrence after ESD operation in early esophageal cancer patients

作　　者：党叶川 李聪丽[1] 王瑞雪[1] DANG Yechuan;LI Congli;WANG Ruixue(Department of Gastroenterology,Sanmenxia Central Hospital,Sanmenxia,Henan,China,472000)

机构地区：[1]三门峡市中心医院消化内科,河南三门峡472000

出　　处：《分子诊断与治疗杂志》2024年第5期812-816,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河南省医学科技攻关计划项目(LHGJ20191439)。

摘　　要：目的 分析研究抑制蛋白基因P53(P53)、抑制蛋白基因P16(P16)及细胞增殖核抗原Ki-67(Ki-67)与早期食管癌患者内镜黏膜下剥离术(ESD)术后复发的关系。方法 选取2019年1月至2023年1月三门峡市中心医院收治80例的早期食管癌患者作为研究对象,均进行ESD治疗。比较所有患者癌组织与癌旁组织(距肿瘤边缘>3 cm,镜下未见肿瘤组织或不典型增生组织)P53、P16、Ki-67蛋白表达。ESD术后对患者随访1年,根据有无术后复发食管癌,将患者分为复发组(n=20)与无复发组(n=60)。比较两组癌组织P53、P16、Ki-67蛋白表达。采用多因素Logistic回归分析早期食管癌患者ESD术后复发的影响因素,并绘制ROC曲线分析P53、P16、Ki-67蛋白表达与早期食管癌患者ESD术后复发。结果 与癌旁组织相比,癌组织P53、Ki-67蛋白表达升高,P16蛋白表达降低(t=9.276、13.987、10.595,均P<0.05);复发组的癌组织P53、Ki-67蛋白表达均高于无复发组,P16蛋白表达低于无复发组(t=5.086、4.648、5.139,均P<0.05);多因素Logistic回归分析显示,肿瘤低分化(OR=1.870)、肿瘤浸润侵犯黏膜下层(OR=1.808)、有淋巴结转移(OR=2.089)、P53蛋白高表达(OR=2.046)、P16蛋白低表达(OR=1.988)及Ki-67蛋白高表达(OR=1.761)均是早期食管癌患者ESD术后复发的独立危险因素(P<0.05);ROC曲线分析显示,P53、P16、Ki-67蛋白表达及联合检测的曲线下面积(AUC)分别为0.803、0.828、0.834、0.942,联合检测优于单一检测(P<0.05)。结论 P53、P16及Ki-67蛋白与早期食管癌患者ESD术后复发情况相关,可以作为辅助预测的相关诊断指标。Objective To investigate the relationship between suppressor protein gene P53(P53),suppressor protein gene P16(P16)and cell proliferating nuclear antigen Ki⁃67(Ki⁃67)and recurrence after endoscopic submucosal dissection(ESD)in patients with early esophageal cancer.Methods 80 patients with early esophageal cancer were admitted to Sanmenxia Central Hospital from January 2019 to January 2023 and were retrospectively selected as the study subjects.All patients underwent ESD treatment.The expression of P53,P16 and Ki⁃67 proteins was compared between cancer tissue and paracancer tissue(defined as tissue more than 3 cm from the tumor margin,with no tumor tissue or atypical hyperplasia observed under the micro⁃scope)in all patients.Patients were followed up for 1 year after the ESD operation and were divided into two groups:the recurrence group(n=20)and the non⁃recurrence group(n=60)based on whether esophageal can⁃cer recurred after the operation.The expression of P53,P16 and Ki⁃67 in the two groups was compared.Multivariate logistic regression was used to analyze the influencing factors of ESD postoperative recurrence in early esophageal cancer patients.ROC curves were drawn to analyze the expression of P53,P16 and Ki⁃67 proteins and ESD postoperative recurrence in early esophageal cancer patients.Results Compared to adjacent tissues,the expression of P53 and Ki⁃67 proteins in cancer tissues was increased,while the expression of P16 protein was decreased(t=9.276,13.987,10.595,P<0.05).The expression of P53 and Ki⁃67 protein in the recur⁃rence group was higher than that in the non⁃recurrence group,and the expression of P16 protein was lower than that in the non⁃recurrence group(t=5.086,4.648,5.139,P<0.05).Multivariate logistic regression analy⁃sis showed that low tumor differentiation(OR=1.870),tumor invasion of submucosa(OR=1.808),lymph node metastasis(OR=2.089),high expression of P53 protein(OR=2.046),low expression of P16 protein(OR=1.988),and high expression of Ki⁃67 protein(OR=1.761)were

关 键 词：早期食管癌 内镜黏膜下剥离术 抑制蛋白基因P53 抑制蛋白基因P16 细胞增殖核抗原Ki-67 

分 类 号：R735.1[医药卫生—肿瘤]