非小细胞肺癌组织p53和c-erbB2及MRP蛋白的表达

目的探讨癌组织p53、c-erbB2、MRP蛋白表达与非小细胞肺癌（NSCLC）临床病理特征的关系及其预后评估意义。方法应用免疫组织化学方法检测NSCLC患者的肺组织切除标本p53、c-erbB2、MRP蛋白表达,并与其临床病理参数进行比较分析。结果NSCLC组织p53、c-erbB2、MRP蛋白表达阳性率分别为53.9%（82/152）、44.1%（67/152）及43.4%（66/152）。p53表达与性别、细胞分化程度、临床分期、淋巴结转移有显著关系（P〈0.05）,而c-erbB2与各因素间无统计学差异,肺腺癌MRP蛋白表达阳性率（67.6%）明显高于肺鳞癌（33.0%）,有统计学差异（P〈0.05）。癌组织p53、c-erbB2、MRP 3种蛋白表达均阳性者的1、2、3年生存率明显低于均阴性者（分别P=0.02、0.01和0.00）,p53、c-erbB2、MRP蛋白表达阳性者单纯手术后生存率也明显低于阴性者（P〈0.05）;p53、c-erbB2、MRP 3种蛋白表达均阴性者预后最好,1-2种阳性者次之,3种均阳性者预后最差（P〈0.05）。术后辅助化疗组MRP、c-erbB2蛋白表达阳性者的生存率低于阴性者（P〈0.01）,但p53蛋白表达阳性与阴性患者的生存率无统计学差异（P=0.82）;MRP与c-erbB2表达双阴性者生存率显著高于双阳性者,MRP或c-erbB2单一阳性的生存率介于前两者之间（P=0.01）。多因素Cox分析显示细胞分化程度、c-erbB2是影响NSCLC患者疗效和预后的独立预测因子。结论肿瘤组织p53、c-erbB2、MRP 3种蛋白同时高表达的NSCLC病例预后较差。术后检测p53、c-erbB2、MRP表达对评估可手术NSCLC患者疗效和预后有一定意义。

Expression of p53,MRP and c-erbB2 in non-small cell lung cancer and its clinicopathological significance

Objective To investigate the expression of p53,c-erbB2 and MRP and its clinicopathological significance in non-small-cell lung cancer (NSCLC). Methods The expressions of p53,c-erbB2 and MRP protein were detected in 152 tumor samples of primary NSCLC by immunohistochemical staining using a polyclonal antibody. The correlation of protein expression with clinicopathologic parameters was analyzed. Results The positive rates of p53,c-erbB2 and MRP expression were 53.9% (82/152), 44.1% (67/152) and 43.4% (66/152), respectively. There was significantly correlation of p53 expression with gender,tumor differentiation,TNM stage and lymph metastasis (P<0.05),but there was no correlation of c-erbB2 expression with clinicopathologic parameters in NSCLCs. MRP positive rate in adenocarcinoma was significantly higher than that in squamous-cell carcinomas (67.6% vs 33.0%,P<0.05). Overall survival was significantly correlated with the co-overexpression of p53,c-erbB2 and MRP proteins. The 1-,2-,3-year survival rates in patients with co-positive p53,c-erbB2 and MRP were 72.6%,54.8% and 32.2%,respectively,which were lower than those in patients with co-negative expression (92.1%,78.5% and 63.4%; P=0.02,0.01 and 0.00).The survival rate in patients who received surgery alone with co-positive expression was lower than that in patients with co-negative expression (P<0.05); and the survival rate of patients who had surgery plus chemotherapy with co-positive c-erbB2 and MRP was lower than that with co-negative (P=0.01). Cox′s model analysis showed that c-erbB2 expression and cell differentiation were independent prognostic factors in patients with completely resected NSCLC. Conclusion p53,c-erbB2 and MRP may be useful indicators in prognosis of NSCLC.