肝细胞癌化疗栓塞后p53蛋白表达及意义

目的　评价肝细胞癌p5 3蛋白表达在经导管动脉化疗栓塞 (transcatheterarterialchemoembolization ,TACE)中的作用。方法　经手术病理证实的肝细胞癌 13 6例 ,其中行 1～ 5次TACE后Ⅱ期手术切除 79例 (TACE组 ) ,按治疗方式不同分 4组 ,A组 ,仅灌注化疗药物 11例 ,治疗 1～ 4次 ;B组 ,化疗药加碘化油栓塞 3 3例 ,治疗 1～ 5次 ;C组 ,化疗药加碘化油加明胶海绵颗粒栓塞 2 3例 ,治疗 1～ 3次 ;D组 ,化疗药加碘化油、无水乙醇、明胶海绵颗粒栓塞 12例 ,治疗 1～ 3次。单纯手术 5 7例 (非TACE组 )。用TUNEL法检测AI ,用免疫组化检测各标本Bcl -2 ,Bax ,p5 3 ,Ki-67和PCNA蛋白表达。结果　梁索型、透明细胞型p5 3蛋白表达显著低于假腺样型、实体型、低分化或未分化型、硬化型 ( P <0 0 5 ) ;随着病理分级的增高 ,p5 3蛋白表达也逐渐增多 ( P <0 0 5 ) ;p5 3蛋白表达与PCNA和Ki-67蛋白表达显著正相关 (P <0 0 5 ) ,与AI ,Bcl-2 /Bax蛋白表达率显著负相关 (P <0 0 5 )。p5 3蛋白表达A组显著高于B、C、D组和单纯手术组 ;B组显著高于C和D组 ;D组显著低于单纯手术组 (P <0 0 5 )。结论　在肝细胞癌化疗栓塞中p5 3蛋白表达起增强癌细胞增殖、抑制细胞凋亡的作用

Expression of p53 Protein of Hepatocellular Carcinoma Cells after Transcatheter Arterial Chemoembolization

Objective To evaluate the significance of p53 protein expression of hepatocellular carcinoma (HCCs) cells after transcatheter arterial chemoembolization(TACE). Methods A total of 136 patients with HCC underwent liver resection. One to five courses of TACE prior to liver resection were performed in 79 patients (TACE group), in which one to four courses of chemotherapy alone were performed in 11 patients (Group A), one to five courses of chemotherapy combined with iodized oil were performed in 33 patients (Group B), one to three courses of chemotherapy combined with iodized oil and gelatin sponge were performed in 23 patients (Group C), and one to three courses of chemotherapy combined with iodized oil, ethanol and gelatin sponge were performed in 12 patients (Group D). The other 57 patients only received liver resection (non-TACE group). The extent of apoptosis was analyzed by transferase-mediated dUTP nick end labeling (TUNEL) staining. The expressions of Bcl-2, Bax, Ki-67 and PCNA proteins were detected by immunohistochemical method. Results p53 protein expressions of trabecular and clear cell HCCs were significantly lower than those of pseudoglandular, solid, poorly differentiated or undifferentiated and sclerosis HCCs (P<0 05). p53 protein expression of HCC cells increased as pathological grades increased (P<0 05). p53 protein expression had positive correlation with expressions of Ki-67 and PCNA proteins, and negative correlation with the expression rate of Bcl-2 to Bax protein and apoptotic index(P<0 05). p53 protein expression was significantly higher in Group A than that in Groups B,C,D and the non-TACE group, was higher in Group B than that in Groups C and D, and lower in Group D than that in the non-TACE group (P<0 05). Conclusion p53 protein expression of HCC cells enhances proliferation of HCC cells and suppresses apoptosis of HCC cells after TACE.