p53蛋白在宫颈鳞癌中的表达及意义

目的　探讨抑癌基因p5 3在宫颈上皮内瘤变 (CIN)及宫颈癌中的表达及意义。方法　采用免疫组化ABC技术 ,观察 15例正常宫颈、2 2例CINⅠ、CINⅡ、16例CINⅢ及 5 2例浸润性宫颈鳞癌 (ISCC)组织中p5 3蛋白表达阳性率及p5 3标记指数 (p5 3 LI)。结果　在正常宫颈和CINⅠ、CINⅡ均未检测到p5 3表达 ,在CINⅢ可检测少量p5 3阳性细胞 ,但其p5 3 LI明显低于ISCC(P <0 0 1) ,p5 3 LI随宫颈鳞癌组织学分级的增高而增高。结论　p5 3蛋白在宫颈癌变过程中发挥着重要作用。     

Prognostic Value of p53 Protein Accumulation in Cancer Cell Nuclei in Adenocarcinoma of the Uterine Cervix

Adenocarcinoma of the uterine cervix (CxAd) is one of the most distressing malignancies of the female reproductive system because of its tendency to spread aggressively and to be resistant to radiation and systemic therapies. To clarify the prognostic significance of p53 alteration in CxAd, we immunohistochemically examined the incidence of p53 nuclear accumulation, which is considered to be mostly parallel with p53 gene mutation, and its association with clinicopathological parameters in 26 patients with CxAd. The overall incidence of p53 nuclear accumulation was 46% (12 of 26), being higher in groups with clinically advanced disease, higher degrees of cellular atypia, and deeper myometrial invasion, but significantly lower in patients with integration of human papillomavirus (HPV) type 16 or 18 DNA. Nuclear p53 immunoreactivity as well as lymph node status, depth of invasion and the absence of HPV-DNA integration were significant indicators of a poor prognosis. Examination of p53 nuclear accumulation could be applied to biopsy material, and would be of practical assistance in predicting the prognosis of CxAd both preoperatively and postoperatively.     

Prognostic Value of PCNA and Mutant p53 Expression in Laryngeal Squamous Cell Carcinoma

The objective of this study was to investigate the prognostic significance of p53, and proliferative cell nuclear antigen (PCNA) in laryngeal squamous cell carcinoma (LSCC). Sixty pathologic specimens from the patients with LSCC were examined for the expression of the p53 and PCNA, with complete follow-up data. Sixty-three percent of the cases displayed nuclear p53 overexpression. There was a correlation between p53 overexpression and histological grades (p = 0.03), and localization site (p = 0.05). Median of PCNA index was 42.2 (range 5.9 to 85.2). There was no difference between the p53 overexpression group and the normal group in proliferative activity determined by PCNA (p = 0.73). In univariate analyses, localization site, grade, stage, invasion pattern, lymph node status, were significant factors in estimating disease free survival (DFS). Grade was the most important factor affecting recurrence (p = 0.002). In multivariate analyses, grade was the only significant predictor for DFS (p = 0.001). Grade (p = 0.001) and invasion pattern (p = 0.03) were found to be significant predictors of overall survival. In conclusion, the histological grade was the most reliable important prognostic factor. Further studies are necessary to facilitate understanding of the mechanisms of laryngeal carcinogenesis.     

p53蛋白在子宫颈癌组织中表达的临床意义

目的 :探讨 p5 3蛋白在子宫颈癌组织中表达的临床意义。方法 :用鼠抗人 p5 3单克隆抗体 ,以 SP免疫组化法检测 p5 3蛋白。结果 :p5 3蛋白阳性表达率为 5 6 .3 % ,其表达与肿瘤大小、TNM分期、有无淋巴结转移无关 (P>0 .0 5 ) ,与肿瘤分化程度有关 (P<0 .0 1)。 p5 3蛋白阳性与阴性组比较 ,其术后生存率差异有显著性 (P<0 .0 1)。结论 :子宫颈癌组织中 p5 3蛋白表达与肿瘤大小、TNM分期及有无淋巴结转移无关 ,与肿瘤分化程度密切相关 ,并可用于判断预后。     

宫颈癌p53和增殖细胞核抗原的关系研究

目的　探讨p5 3蛋白和增殖细胞核抗原 (PCNA)在宫颈癌的表达及相关性。方法　采用免疫组化ABC法检测 5 2例浸润性宫颈鳞癌 (ISCC)组织中p5 3蛋白标记指数 (p5 3-LI)和PCNA标记指数 (PCNA -LI)。结果　p5 3 -LI和ISCC组织分化级别呈正相关 ,PCNA -LI与之无关 ,p5 3阴性和阳性两组间PCNA -LI无明显差异 ,p5 3阳性表达的宫颈鳞癌中 ,p5 3 -LI和PCNA -LI呈直线正相关。结论　p5 3和PCNA的表达与宫颈鳞癌细胞的增殖状态有关。     

p53蛋白在卵巢癌组织中的表达及其意义

目的：探讨ｐ５３蛋白表达与ＤＮＡ倍体、临床分期、病理分级及预后的关系。方法采用流式细胞仪双参数检测了５４例临床卵巢肿瘤手术标本的ＤＮＡ含量和Ｐ５３蛋白表达。其中良性肿瘤６例,卵巢癌４８例。同时采用免疫组化方法检测上述样本２０例的石蜡切片。观察Ｐ５３蛋白表达。结果经统计分析,采用免疫组化ＡＢＣ法和流式细胞仪法检测的Ｐ５３蛋白表达者有明显一致性（Ｐ〈０．０１）。良恶性肿瘤组织中ｐ５３蛋白表达有显著性差     

p53蛋白表达对不同部位大肠癌患者预后判断的价值

目的　探讨p5 3蛋白过度表达对不同部位大肠癌患者预后判断的价值。方法　应用免疫组化方法检测 75例大肠癌组织中 p5 3蛋白表达情况。 结果　p5 3蛋白表达阳性率为 46.7% (3 5 / 75 )。远侧大肠癌 p5 3蛋白表达率 (5 9.5 % )显著高于近侧者(3 0 .3 % ) (P <0 .0 5 )。p5 3蛋白表达与其它临床病理因素无明显相关。全组中位数随访时间为 60个月 ,p5 3蛋白表达阳性与阴性患者术后总生存率比较有显著性差异 (P <0 .0 5 )。在远侧大肠癌组织中 p5 3阳性患者的预后明显差 (P <0 .0 1)。而在近侧大肠癌中 ,2组患者的预后则无显著性差异 (P >0 .0 5 )。结论　不同部位大肠癌 p5 3蛋白表达存在一定差异 ,p5 3蛋白过度表达对远侧大肠癌患者预后判断有重要作用     

食管癌p53、p16、PCNA蛋白表达的临床意义

[目的]探讨p53、p16、PCNA蛋白在食管癌中的表达及临床价值。[方法] 用免疫组织化学染色SP法对50例食管癌标本进行p53、p16、PCNA蛋白测定。[结果] 50例食管癌中，p53、PCNA蛋白阳性表达均为74％（37／50），P16缺失率52％（26／50）。p16缺失与肿瘤浸润深度、淋巴结转移密切相关（P〈0．05、p〈0．01）。而p53、PCNA蛋白同时表达56％（28／50），亦与肿瘤浸润深度、淋巴结转移密切相关（P〈0．05、p〈0．01）。[结论] 食管癌p53、PCNA蛋白同时表达及p16缺失可视为危险预后因素。     

p14ARF在宫颈癌中的表达及其与p53表达相关性的研究

目的探讨宫颈癌组织p14ARF蛋白的表达及其与p53表达的相关性.方法应用免疫组化方法检测p14ARF、p53基因在41例宫颈癌及20例正常宫颈组织中的表达.结果p14ARF在正常宫颈组织中不表达,41例宫颈癌中35例表达阳性,占85.4%.病理分级为G1、G2级的宫颈癌的p4ARF阳性表达率为68.4%,G3级为100%,两者比较,有显著性差异(P＜0.05).宫颈癌组织中p53蛋白表达阳、阴性者中p14ARF蛋白表达阳性率分别为75.0%(12/16)和92.0%(23/25),两者比较,无显著性差异,p14ARF与p53表达不相关.结论p14ARF在宫颈癌中高表达有一定的诊断和估测预后价值,可能是宫颈癌新的肿瘤标志物.     

Limited Value of Vaginal Cytology in Detecting Recurrent Disease After Radical Hysterectomy for Early Stage Cervical Carcinoma

The objective of this study was to evaluate the value of vaginal cytology in routine surveillance for recurrentcervical cancer after surgery. We reviewed the medical records of 565 patients with stage IB-IIA cervical cancer whowere treated with radical hysterectomy and pelvic lymphadenectomy (RHPL) and attended follow- up at ChiangMai University Hospital between January 2000 and May 2006. With the median follow-up of 35 months (range 1-76months), 23 (4%) patients developed recurrence. The interval from surgery to detection of recurrence ranged from5-61 months with a median of 23 months. Of the total 4,376 vaginal smears, 5 (0.1%) showed abnormal cytology butonly 1 had malignant cells and tumor recurrence. The sensitivity and specificity of vaginal cytology for detection ofrecurrence were 4.3% and 99.3%, respectively. In conclusion, vaginal cytology has limited value in detection ofrecurrence after RHPL for early-stage cervical cancer.     

HPV16感染p53及MDM2蛋白表达在宫颈癌中的意义

目的：检测新疆维吾尔族（维族）宫颈癌中HPV16感染、p53和MDM2蛋白表达情况，探讨三者在宫颈癌致癌机制中的相互作用及意义。方法：应用半巢式PCR及免疫组化方法检测79例宫颈鳞癌（实验组）、40例正常宫颈组织（对照组）中HPV16 DNA和1753、MDM2蛋白表达，结果：1）实验组中HPV16 DNA检出率为81．O％（64／79），高于对照组7．5％（3／40），两组比较有显著性差异（x^2=58．328，P=0．000）、2）实验组中p53蛋白表达率为68．4％（54／79），高于对照组12．5％（5／40），两组比较有显著性差异（x^2=33．140，P=0．000）.3）实验组中MDM2蛋白表达率为39．2％（31／79），高于对照组10．0％（4／40），差异有显著性（）（x^2=10．936，P=0．001）。结论：时HPV感染和p53、MDM2蛋白表达关系的分析显示，在大多教HPV阳性的宫颈癌中p53和MDM2蛋白表达一致，其相互作用在宫颈癌的发生、发展中具有重要意义；在HPV阴性的宫颈癌中，可能主要由MDM2基因通过p53依赖和p53非依赖两条途径发挥致癌作用另外．HPV、p53和MDM2也可能各自具有独立的致癌作用.     

Clinicopathologic and Diagnostic Significance of p53 Protein Expression in Papillary Thyroid Carcinoma

Background: p53 protein expression has been detected immunohistochemically in papillary thyroidcarcinoma(PTC). We investigated the relations between its expression and clinicopathologic features and itssignificance as a diagnostic marker. Materials and Methods: We compared and evaluated 93 patients in whomthyroidectomy with lymph node dissection had been performed to treat PTC for clinicopathologic significanceand 102 patients with 23 papillary thyroid overt carcinomas (POC), 57 papillary thyroid microcarcinomas(PMC),5 follicular adenomas (FA), 5 Hashimoto’s thyroiditis (HT) and 12 nodular hyperplasias (NH) for significanceas a diagnostic marker. Expression of p53 protein was evaluated immunohistochemically in sections of paraffinembeddedtissue. Results: Statistical analysis showed significantly different expression of p53 in PTC versusother benign thyroid lesions (BTL).The diagnostic sensitivity and specificity were 85.0% and 72.7%, respectively.Overexpression of p53 protein was observed in 44 of the 93 PTC cases (47.3%), but no significant correlationbetween p53 protein overexpression and clinicopathologic features (age, size, multiplicity, lymph node metastasis,extrathyroidal extension and vascular invasion) was noted. Conclusions: p53 is valuable to distinguish PTC fromother BTL, but there is no correlation between p53 protein overexpression and clinicopathologic features.     

p53在宫颈鳞癌组织中的表达及其意义

目的 通过检测宫颈鳞癌组织p53功能表达状况，观察p53功能表达对宫颈鳞癌预后的影响，以指导治疗。方法 采用western印迹法检测60例宫颈鳞癌组织中p53功能表达。60例宫颈癌患者中位年龄44岁；FIGO分期：Ⅰa期3例，Ⅰb期31例，Ⅱa期10例，Ⅱb期16例。用SPSS10．0统计软件包分析不同的p53功能表达对宫颈鳞癌生物学行为的影响及预后的差异。结果 p53功能表达异常之宫颈鳞癌（16例），其病理分级以Ⅲ级为主（P〈0．01），深肌层浸润及淋巴结转移较p53功能表达正常者（44例）常见（P〈0．01），有50．0％（8／16）的病例在1年内复发（P〈0．01），3年生存率（42．6％）较p53功能表达正常者（78、3％）为低（P〈0、01），平均生存时间（32，93个月）较p53功能表达正常者（60．69个月）明显为短（P〈0．01）。结论 p53功能表达异常者，癌的恶性程度及复发率高，患者的生存期短。     

病理学切缘和以p53与eIF4E为指标的分子切缘预测喉癌患者预后

目的探讨病理学切缘和以p53、eIF4E为指标的分子切缘在预测喉癌患者预后中的价值。方法选择了253例喉癌患者进行病理学切缘研究，在以上病理学阴性切缘中选择67例，应用免疫组化方法检测p53、eIF4E蛋白的表达以进行分子切缘研究。结果1．病理学切缘、p53切缘、eIF4E切缘的阳性率分别是20．2％，19．4％和32．8％；2．阳性切缘患者的复发率高于切缘阴性者，包括病理学切缘(70．6％vs35．1％，P=0．0000)、p53切缘(69．2％vs33．3％，P=0．018)、eIF4E切缘(63．6％vs28．90A，P=0．018)；而切缘阳性者5年累积生存率低于切缘阴性者，包括病理学切缘(37．52％vs64．37％，P=0．0023)、p53切缘(24．62％vs75．69％，P=0．0012)、eIF4E切缘(43．31％vs77．52％，P=0．0006)。结论病理学切缘和以p53、eIF4E为指标的分子切缘阳性者的预后比切缘阴性者差，而p53和eIF4E可以从病理学切缘阴性者中发现预后更差的患者，并且eIF4E可能是优p53的分子指标。     

Prognostic Value of Tumor Budding in Early-Stage Cervical Adenocarcinomas

Background: Tumor budding has recently been reported as an independent adverse prognostic factor for colorectal adenocarcinomas and other types of carcinoma in the digestive tract. This study aimed to evaluate the prognostic value of tumor budding in patients with early-stage cervical adenocarcinomas and any associations with other clinical and pathological features. Methods: Histological slides of patients with early-stage (IB-IIA) usual-type endocervical adenocarcinoma who underwent radical hysterectomy and pelvic lymph node dissection, without preoperative chemotherapy, between January 2006 and December 2012 were reviewed. Tumor budding was evaluated in routinely-stained sections and defined as detached single cells or clusters of fewer than 5 cells in a tumor invasive front and was stratified based on the number of bud counts in 10-high-power fields as low (follow-up outcomes were assessed. Results: Of 129 patients, a high tumor bud count was observed in 15 (11.6%), positively associated with histologic grade 3 (p<0.001), invasive pattern C (Silva System) (p=0.004), lymph node metastasis (p=0.008), stage IB2-IIA (p=0.016), and tumor size >2 cm (p=0.036). Kaplan-Meyer analysis showed a significant decrease in both disease-free survival and cancer-specific survival for patients with a high tumor bud count (p=0.027 and 0.031, respectively). On multivariate analysis, histologic grade 3 was the only independent predictor for decreased disease-free survival (p=0.004) and cancer-specific survival (p=0.003). Conclusions: A high tumor budding count based on assessment of routinely-stained sections was found to be associated with decreased disease-free and cancer-specific survival in patients with early-stage cervical adenocarcinomas. However, it was not found to be an independent prognostic predictor in this study.     

宫颈癌及慢性宫颈炎ras癌基因产物p21和DNA倍体的研究

应用细胞免疫荧光技术和流式细胞术对宫颈癌和慢性宫颈炎组织ras癌基因产物p21蛋白的表达量进行了定量研究，并分析了rasp21的表达量与DNA倍体和细胞增殖指数的关系。结果显示：宫颈癌rasp21的表达量（荧光指数FI）明显高于慢性宫颈炎组织，rasp21表达的荧光指数随组织学分级升高而增高。DNA倍体和rasp21的表达量有密切关系。     

Prognostic Value of the Expression of Tumor Suppressor Genes p53, p21, p16 and pRb, and Ki-67 Labelling in High Grade Astrocytomas Treated with Radiotherapy

Cumulative inactivation of tumor suppressor genes and/or amplification of oncogenes lead to progressively more malignant astrocytic tumors. We have analyzed the significance of tumor suppressor genes p53, p21, p16 and retinoblastoma protein (pRb) and proliferative activity for survival in 77 high grade astrocytic tumors.After operation, the patients – 25 anaplastic astrocytomas (AA) and 52 glioblastomas (GBs) – were treated with similar radiotherapy. The expression of the suppressor genes and the proliferative activity were analyzed immunohistochemically.p53 immunopositivity was found in 44% of AAs and 46% of GBs. Tumors with aberrant p53 expression had lower proliferation indices than p53 immunonegative tumors. Neither p53 expression nor p21 immunonegativity (52% of AAs and 48% of GBs) correlated with survival. p16 immunostaining was negative in 16% of AAs and in 44% of GBs, and it correlated inversely with survival in both uni- and multivariate analyses. pRb immunostaining was negative only in 8% of both AAs and GBs and the absence of p16 and pRb were mutually exclusive.Ki-67 labelling index (LI) was significantly higher in GBs (26.8%) than in AAs (20.3%), and in multivariate analysis it was an independent prognostic factor for survival. In 48% of AAs Ki-67 LI exceeded 20% and this subset of AAs had similar prognosis as GB.In high grade astrocytic tumors p16 immunonegativity was an independent indicator of poor prognosis in addition to the previously established patient's age, histopathology and Ki-67 LI. Furthermore, there was a subset of AAs with a high proliferation rate (>20%) in which the histopathological hallmarks of GB were lacking, but which had similarly dismal prognosis as GB.     

Survivin、p53表达与宫颈鳞癌预后的关系

[目的]探讨survivin、p53与宫颈鳞癌预后的关系。[方法]用免疫组化法对79例宫颈鳞癌p53、survivin基因表达进行检测,分析survivin、p53与宫颈癌患者临床病理特点及预后的关系。[结果]宫颈癌患者的淋巴转移与survivin表达显著相关(P<0.05)。Survivin与p53表达显著相关(P<0.05)。宫颈癌患者的分期及survivin基因表达对其预后有显著影响,P值分别为0.0047及0.0453。[结论]宫颈癌的分期及survivin基因表达为独立的预后影响因素。     

p53 and BCL-2 as Prognostic Markers in Endometrial Carcinoma

The objective of this study was to verify the frequency of p53 and BCL-2 immunohistochemical expression in patients with endometrial carcinoma and to correlate it with histological factors (histological type, tumor grade, depth of myometrial invasion, lymph node involvement and surgical staging) and survival. Forty-eight patients with endometrial carcinoma who were submitted to primary surgical treatment were assessed. p53 and BCL-2 immunohistochemical expression was determined using paraffin blocks containing the tumor area. p53 and BCL-2 expression was detected in 39.6% and 58.3% of the tumors, respectively. No significant difference was found regarding the frequency of p53 expression when analyzing histological type (33.3% in endometrioid tumors, 58.3% in non-endometrioid tumors; p = 0.176), depth of myometrial invasion (p = 0.632) and surgical staging (I—11.1%, II—66.7%, III—57.1%; p = 0.061). p53 expression was significantly more frequent in undifferentiated tumors (p = 0.007) and in those showing lymph node involvement (p = 0.030). Univariate analysis showed a positive association with death (RR, 3.358; CI, 1.386–8.134; p = 0.005) and short-term survival. The present study did not reveal any correlation between BCL-2 expression and histopathologic markers or survival. In conclusion, this study showed that p53 expression is directly correlated with undifferentiated tumors, lymph-node involvement and risk of death. On the other hand, BCL-2 expression was not correlated with any known histological factors.     

子宫颈上皮内瘤样病变及鳞癌中p53与MDM2表达及相关性

目的　了解子宫颈上皮内瘤样病变 (CIN)及鳞癌 (SCC)中p5 3与MDM2表达及相关性。方法　用免疫组化SP法检测MDM2及p5 3蛋白在正常宫颈上皮、CIN、SCC中的表达 ,共 76例。结果　①随着宫颈病变加重 ,MDM2、p5 3表达率均渐增高 ,二者在正常宫颈、CIN、SCC的表达率分别为 :MDM2的表达为 0、13 64 %、44 12 % ;p5 3的表达为 5 0 0 %、18 18%、47 0 6%。MDM2、p5 3在浸润癌组较CIN及正常宫颈组明显增高。②MDM2的表达与p5 3的聚积在统计学上未显示出有相关性。结论　MDM2、p5 3可能参与宫颈癌的发生、发展 ,对宫颈癌的诊断和治疗具有一定意义。