非小细胞肺癌组织中p53蛋白的表达对预后以及术后化放疗疗效的影响

 目的 探讨p53蛋白表达对非小细胞肺癌术后化疗、放疗疗效的影响。方法 应用免疫组化LSAB方法检测非小细胞肺癌石蜡切片中p53蛋白的表达情况，选取18例根治术后行含铂类辅助化疗和20例根治术后行辅助放疗的Ⅲa期非小细胞肺癌，选同期单独手术的15例Ⅲa期患者作对照，应用Kaplan-Meier法和多变量Cox比例风险模型进行分析。结果 p53蛋白表达与年龄、T分期之间未发现相关性（P ＞0.05），但与组织学分级呈负相关（P＜0.05），与组织学类型呈正相关（P＜0.05）；p53蛋白表达阳性率为54.72 %，在单纯手术组、术后化疗组和术后放疗组中阳性者和阴性者生存率差异有统计学意义（P＜0.05）；Cox多因素分析结果显示p53是影响术后化疗和放疗效果的独立指标。结论 p53蛋白表达是预后较差的指标之一，p53蛋白表达阳性者较阴性者对化疗和放疗不敏感，如何提高化放疗疗效尚需深入研究。

Effects of p53 expression on prognosis and adjuvant chemotherapy and radiotherapy in NSCLC

Objective To determine the effects of p53 expression on adjuvant chemotherapy and radiotherapy in NSCLC.Methods Expression of p53 in 18 patients with NSCLC who received radical surgery and cisplatin-based chemotherapy after operation and 20 patients received radiotherapy after radical operation were determined by LSAB immunohistochemical method in contrast with 15 patients with NSCLC received surgery alone.Kaplan-Meier method and Cox proportional hazard model were used to analyze.Results The expression of p53 had no relationship with age and T stage,but had negative relationship with histological grade and positive relationship with histologic subtype.The positive rate of p53 was 54.72 %,there was significant difference between patients with positive and negative p53 protein expression in single surgery,surgery plus chemotherapy and surgery plus radiotherapy group.Cox's model showed that p53 had separate and significant impacts on prognosis in surgery plus chemotherapy group and surgery plus radiotherapy group.Conclusions Overexpression of p53 protein suggests a poor prognosis,and has tendency to resist chemotherapy and radiotherapy in NSCLC.