检测Dukes’B期结直肠癌微转移及P53的临床意义(英文)  

Clinic study on lymph node micrometastasis and P53 of Duke's stage B colorectal cancer

作　　者：张丽萍[1] 申戈[2] 李国民[3] 鲍云华[2] 

机构地区：[1]海军总医院放射肿瘤科,北京100037 [2]军事医学科学院附属医院肿瘤科,北京100039 [3]军事医学科学院附属医院病理科,北京100039

出　　处：《中国现代医学杂志》2004年第2期13-16,共4页China Journal of Modern Medicine

摘　　要：目的　Dukes’B期结直肠癌患者手术后 5年生存率为 5 3.9%～ 84 .9% ,有部分患者 5年内出现局部复发或 /和远处转移。该研究旨在探讨淋巴结微小转移灶 (lymphnodemicrometastasisLMM)及原发灶P5 3的表达对评估经手术切除原发肿瘤及肠周淋巴结的Dukes’B期结直肠癌患者预后的重要性。方法　收集 5 2例Dukes’B期结直肠癌患者手术切除的淋巴结及原发灶石蜡标本 ,同时获得这些病例的临床资料及随访资料 ;实验方法 :以细胞角蛋白单抗AE1/AE3 为探针 ,采用免疫组化SAP(streptavidin -alkalinephosphatase)法检测淋巴结中的LMM。以P5 3单抗为探针 ,采用免疫组化S -P(streptavidin -peroxidase)法检测原发灶P5 3蛋白的表达。结果　检测 5 2例Dukes’B期结直肠癌患者的 5年生存率为 73%。淋巴结中LMM +组 5年生存率 4 5 .5 % ,LMM -组 78.9%。原发灶中P5 3+组 5年生存率 6 2 .5 % ,P5 3-组 87.5 %。同时检测LMM +P5 3+组33% ,LMM -P5 3-组 84 %。χ2 检验均P <0 .0 5 ,生存分析log-rank检验P <0 .0 5。结论　用免疫组化法检测Dukes’B期结直肠癌患者经手术切除后肠周淋巴结中的微小转移灶及原发灶P5 3蛋白对判断患者预后及指导术后治疗均有临床意义。Objective: To investigate the lymph node micrometastasis and P53 protein expression and their clinical significance for prognosis. Methods: The paraffin- embedded lymph node samples of 52 patients were and collected. The clinical material and follow-up information of all 52 patients were obtained. The immunocytochemical staining method was SAP method to detect the micrometastasis in lymph nodes using the monoclonal antibody AE 1/AE 3. The other was SP method to detect P53 protein in the primary tumor tissue using the monoclonal antibody P53. Results: There were 73% patients survived more than 5 years in the 52 patients. The 5-year survival rat was 45.5%in LMM+ group and 78.8 % in LMM-group, 62.5%in P53+ group and 87.5 %P53- group.The postoperative 5-year survival rate in LMM+P53+ group was shorter than in other groups. Micrometastasis in lymph nodes and P53 protein expression for patients with Dukes’B colorectal cancer were associated with decreased survival time. Conclusions: The detection of micrometastasis in lymph nodes and P53 in primary tumor tissue in patients with Dukes’B colorectal cancer by immunohistological method obviously influenced survival time, which has significance in guiding postoperative treatment. Therefore,the method is recommended.

关 键 词：结直肠癌 免疫组化 微小转移灶 细胞角蛋白 P53蛋白 

分 类 号：R735.34[医药卫生—肿瘤]