p53表达与肝细胞癌临床病理学特征及AFP、HBV感染之间的关系研究

目的:探讨p53与肝细胞癌临床病理学特征和患者预后、AFP、HBV感染之间的关系.方法:应用免疫组化方法,检测70例肝细胞癌和20例肝良性肿瘤标本p53的表达;结合肝细胞癌临床分期、病理分级、门静脉癌栓、术后生存期、血清甲胎蛋白(AFP)、乙型肝炎病毒(HBV)感染等资料进行统计分析.结果:肝细胞癌的p53阳性率显著高于肝良性肿瘤(P＜0.01);p53阳性表达与肝细胞癌患者的性别、年龄、肿瘤大小、肝硬化、临床分期均无显著性相关(P＞0.05);包膜不完整、并有门静脉癌栓、分化未成熟及血清AFP阳性的肝细胞癌组织的p53阳性率明显高于有完整包膜、无门静脉癌栓、分化较成熟及血清AFP阴性的组织(P＜0.05) ;HBsAg阳性的肝细胞癌p53阳性率显著高于HBsAg阴性者(P＜0.01);p53阳性的肝细胞癌患者术后2年存活率显著低于阴性者 (P＜0.01).结论:p53是评价肝细胞癌恶性程度及预后的一个有价值的生物学指标;它的表达与肝细胞癌患者的血清AFP水平及HBV感染有密切相关性.

THE EXPRESSION OF p53 PROTEIN AND ITS RELATIONSHIP WITH CLINICAL PATHOLOGICAL FEATURE AND AFP, HBV INFECTION IN HEPATOCELLULAR CARCINOMA

Objective: To investigate the expression of p53 protein in hepatocellular carcinoma (HCC) and its relationship with clinical pathological feature and prognosis of HCC and alpha-fetopritein (AFP), hepatitis B virus (HBV) infection in HCC. Methods: The expression of p53 protein in 70 specimens of HCC and 20 specimens of benign hepatic tumor was detected by immunohistochemical S-P method. It's relationship with clinical and pathology grade of HCC, portal venous tumor emboli, postoperative survival rate, AFP and HBV infection was statistically analyzed. Result: The expression rate of p53 protein in HCC was significantly higher than that in benign hepatic tumor (P<0.01). There was no significant relation between the expression of p53 and patients' sex, age, clinical stage, tumor size, and cirrhosis of the HCC (P>0.05). The p53 protein was expressed more frequently in HCC with incomplete capsule , venous tumor emboli, poorly differentiated or serum AFP-positive than in those with complete capsule , no venous tumor emboli, maturely differentiated or serum AFP-negative (P<0.05). A similar result was also observed in HbsAg-positive and HbsAg-negative HCC group (P<0.01). Meanwhile, the postoperative 2-year survival rate of patients with HCC with p53 gene expression was significantly lower than those without p53 gene expression (P<0.01). Conclusion: p53 gene can be used as a valuable index in evaluation of the malignant degree and prognosis of HCC. The expression of p53 protein in HCC is closely related to serum AFP level and HBV infection.