检测Dukes'B期结直肠癌微转移及P53的临床意义

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。

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

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 AE1/AE3. 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.