大肠癌P21WAF1/CIP1和P53蛋白表达及其与预后的关系

目的 探讨细胞周期调控因子P212^WSAF1／CIP1和P53蛋白表达在大肠癌发生发展中的作用及其临床意义。方法 采用免疫组化染色对113例大肠癌P21和P53的蛋白表达进行了检测。结果 高分化腺癌P21蛋白阳性表达率显著高于低分化腺癌（P＜0．05），大肠癌中P53、P21^WAF1／CIPI蛋白表达进行了检测。结果 高分化腺癌P21蛋白阳性表达显著高于低分化腺癌（P＜0．05），大肠癌中P53、P21^WAF1/CIP1蛋白表达有显著负相关（r＝－0．585，P＜0．01）。P53阳性表达患者的3、5年生存率显著低于阴性表达者（P＜0．05），而P21阳性表达者高于阴性表达者，且P21^ /P53^-大肠癌死亡率较P21^-/P53^ 患者显著降低。结论 P21蛋白过度表达可能与大肠癌发化有关，p53基因突变，介导P21蛋白产生减少，阻止细胞周期的作用减弱，从而加速大肠癌的发展。P21与P53蛋白联合检测可能有助于其预后判断。

Expression of P21WAF1/CIP1 and P53 and its relation with prognosis in large intestine carcinoma

Objective To explore the expression of cell cycle the P21WAF1/CIP1 and P53 in colorectal carcinogenesis, and their clinical sig- nificance. Methods The expressions of P21 and P53 in 113 cases of colorectal carcinomas were detected by immunhistochemical technique. Re- Sults The expression of P21 protein was significantly lower in poorly differentiated adenocarcinomas in well differentiated one (P < 0. 05). Furthermore, P21 and P53 staining were inversely correlated with each other (r = -0.585, P < 0.01). The 3 or 5 year survival rate was signifi- cantly lower in the P53 positive tumor patients than that in P53 negative patients (P < 0.05), the 3 or 5 year survival rate in the patients with P21 strongly positive tumors was higher than that with P21 negative tumors. The mortality in patients with P21 + /P53- tumors was significant lower than that with P21- /P53+ tumors (P < 0.05). Conclusion The overexpression of P21 protein might inhibit the tumor cell proliferation and induce the differentiation of carcinoma cells, and the p53 gene mutation might reduce the expression of P21 protein, and promote the progression of colorectal carcinoma. The combined assessment of P53 and P21 expression might be useful for the prognosis of colorectal carcinoma.