鼻腔NK/T细胞淋巴瘤中P53、P21表达及其临床意义

目的 探讨P53、P21蛋白在鼻腔NK/T细胞淋巴瘤(NKTL)中的表达及其与细胞增殖、凋亡、临床分期和预后的关系.方法 收集62例NKTL患者的临床病理资料,并进行随访.取62例NKTL组织构建组织芯片,应用免疫组化方法 检测P53、P21、Ki67蛋白的表达,TUNEL法原位凋亡检测,计算增殖指数(PI)和凋亡指数(AI).结果 P53、P21蛋白在NKTL中表达的阳性率分别为79.03%、58.06%.P53和P21在Ann Arbor Ⅰ、Ⅱ、Ⅲ、Ⅳ期患者中表达的阳性率分别为69.57%、75.00%、86.67%、100.00%和47.83%、56.25%、60.00%、87.50%,随着肿瘤进展,二者表达阳性率逐渐升高,差异具有统计学意义(P＜0.05).P53和P21二者表达具有明显的正相关性(r=0.467,P＜0.05),其阴性表达组预后好于阳性表达组(P＜0.05);P53蛋白表达是独立预后因素.随着P53、P21蛋白表达强度的增加,PI亦逐渐升高,它们均与PI呈正相关(r=0.177,0.184,P＜0.05),而与AI无关联性(P＞0.05).结论 P53、P21蛋白表达与NKTL的发生、发展密切相关,联合检测Ki67表达,可作为评估该病患者肿瘤细胞增殖、侵袭性等生物学行为的良好指标,为临床治疗及预后评价提供依据.

Expression and Significance of P53 and P21 in Nasal NK/T-cell Lymphoma

Objective To investigate the significance of P53 and P21 expressions in nasal NK/T-cell lymphoma(NKTL)and their relationships with the clinical stage,prognosis,proliferation and apoptosis of tumor cells.Methods The clinicopathologic and follow-up data was collected from 62 patients with NKTL proven by pathological examination..Sixty-two cases of NKTL were examined for P53,P21 and Ki67 proteins with tissue microarray technique and immunohistochemistry.TUNEL method was used to detect apoptosis(apoptosis index,AI).The proliferation index(PI)was determined by the expression of Ki67 proteins.Results The positive rates of P53 and P21 protein expression in NKTL were 79.03%and 58.06%respectively.The positive rates of P53 in Ann Arbor stage Ⅰ,Ⅱ、Ⅲ and Ⅳ NKTL were 69.57%,75.00%,86.67%and 100.00%respectively,while those of P21 were 47.83%,56.25%,60.00%and 87.50%.With the progression of tumor,the positive expression rates of P53 and P21 proteins gradually increased.And there were significant differences statistically between the expressions of P53/P21 and Ann Arbor stage(P＜0.05).The expression of P53 was positively correlated with the expression of P21(r=0.467,P＜0.05).The prognosis of P53 and P21 positive expression group was worse than that of negative expression group(P＜0.05).The expression of P53 protein was an independent prognostic factor.The intensities of P53 and P21 expressions were positively correlated with PI(r=0.177,0.184,P＜0.05),while not correlated with AI(P＞0.05).Conclusion The expressions of P53,P21 and Ki67 proteins are closely related with the pathogenesis and progression of NKTL.Combined detection of P53,P21 and Ki67 could be better to judge the biological behavior of NKTL.