P53蛋白及EGFR在肺癌中的表达及其意义

应用S－P免疫组化法对85例肺癌及25例肺良性疾病标本进行了P53蛋白及EGFR的检测。结果：P53蛋白在肺癌中的阳性率为50．6％（43／85）。鳞癌及大细胞癌阳性率显著高于腺癌及小细胞癌的阳性率（P＜0．05）。肺良性疾病标本均阴性。P53蛋白阳性者的淋巴结转移率（79．1％，34／43）显著高于P53蛋白阴性者的转移率（57．1％，24／42）（P＜0．05）。提示P53蛋白在肺癌的发生发展及转移中起重要作用。EGFR在肺癌中的阳性率为72．9％（62／85），而在肺良性病变中为12％（3／25），两者阳性率差异显著（P＜0．05）。EGFR过度表达与肺癌病理类型及是否发生转移均无相关性。肺癌癌旁组织EGFR阳性率65．3％（62／95）。增生组癌旁组织阳性率（81．0％，47／58）显著高于无增生组阳性率（40．5％，15／37）（P＜0．05），无增生组癌旁组织阳性率显著高于肺良性疾病阳性率（P＜0．05）。提示EGFR过度表达与癌旁组织的增生密切相关，可能是肺癌发生的早期事件，在肺癌的发生中起重要作用。P53蛋白及EGFR共同表达者淋巴结转移率（85．3％，29／34）显著高于非共同阳性者的转移率（48．8％，21／43）（P＜0．01）。因此，P53蛋白及EGFR共同阳性提示肺癌具有高度转移潜能，预后可能较差。

EXPRESSION AND SIGNIFICANCE OF P53 PROTEIN AND EGFR IN LUNG CARCINOMA

The expression of P53 and EGFR in primary lung cancer(n=85) and lung benign lession(n=25)was examined by means of S-P immunohistochemistry. The positive rate of P53 protein inlung cancer was 50. 6% (43/85),and was significantly higher in squamous and large cell carcinoma than that in adenocarcinoma arid small cell carcinoma(p<0. 05). None of lung benign lession was positive. The rate of lung cancer metastasis was higher in the cases with positive P53 protein (81. 0 % ) than in those with negative P53 protein (56. 9 %,P<0. 05 ). It suggested that P53 protein plays an important role in pathogenesis and progress of lung cancer and that the cases with positive P53 protein have a stronger potential of metastasis. Overexpression rates of EGFR were 72. 9 % (62/85 ) in lung cancer, 12. 0% (3/25 ) in lung benign lession, and showed a significant difference (P<0. 05). There was no correlation between EGFR expression and pathological types and metastasis of lung cancer. The expression rate of EGFR in paracancerous lession was 65. 3%(62/95 ), and higher in the hyperplastic (81. 0 %, 47/58) than in the non-hyperplastic (40. 5 % )(P<0. 01 ). It suggested that the overexpression of EGFR may be an early event,and may play an important role in pathogensis and development of lung cancer. The cases of simultaneous abnormal expression of P53 and EGFR had an obviously higher metastasis rate (85. 3%, 29/34)than those without simultaneous expression (48. 8 %, 21 /43 ) (P<0. 05). Therefore the lung cancer with expression of both P53 protein and EGFR may possess higher potential of metastasis anda poorer clinical prognosis.