p53和nm23联合表达对食管鳞癌淋巴结转移的影响

目的：探讨ｐ５３ 和ｎｍ２３ 表达作为食管鳞癌转移标志物的实用价值。方法：采用免疫组化方法检测８５ 例原发性食管鳞癌中ｐ５３ 和ｎｍ２３ 蛋白表达。结果：６３－５３ ％ （５４／８５） 肿瘤呈ｐ５３ 阳性表达，ｐ５３ 阳性表达与肿瘤淋巴结转移和ＴＮＭ 分期有关（Ｐ值均为０－００１）。４０ ％（３４／８５） 肿瘤为ｎｍ２３ 低表达。ｎｍ２３ 低表达与肿瘤浸润深度、淋巴结转移、ＴＮＭ 分期有关（ Ｐ值分别为０－０３２、０－００１、０－００１） 。单因素分析显示：ｐ５３ 和ｎｍ２３ 表达为影响淋巴结转移的主要因素（ ＯＲ值分别为６－９８４ 和０－０８７，Ｐ＜０－００１）。多因素分析显示：ｎｍ２３ 表达是影响淋巴结转移的一个独立因素（珘ｂ＝ － ０－８４８１ ， ＯＲ＝ ０－１８１， Ｐ＝ ０－０００１） 。ｐ５３阳性肿瘤具有高度淋巴结转移的倾向（珘ｂ＝ ０－３１５０， ＯＲ＝２－２８４，Ｐ＝ ０－０５６５），其它临床病理学参数与淋巴结转移之间未见明显关系（Ｐ＞ ０－０５） 。ｐ５３ 和ｎｍ２３ 异常表达之间呈负相关（ｒｓ＝ － ０－３８４９ ，Ｐ＝ ０－０００３），在促进肿瘤的进展和转移过程中起联合作用。结论：ｐ５３ 和ｎｍ２３ 联合表达对判断食管鳞癌患者

Influences of p53 and nm23 co-expressions to lymph node metastasis in esophageal squamous cell carcinoma

Purpose To investigate the applied value of p53 and nm23 expression as markers of lymph node metastasis (LNM) in esophageal squamous cell carcinoma (ESCC). Methods The expression of p53 and nm23 proteins were studied immunohistochemically in 85 primary ESCC. Results p53 over expression was observed in 63 53%(54/85) of carcinoma tissues. It was associated with LNM and the TNM staging ( P =0 001). In 40%(34/85) of tumors, nm23 expressions were negative, with correlated with the depth of invasion, LNM and TNM staging ( P =0 032, 0 001 and 0 001, respectively). Univariate analyses showed that p53 and nm23 expression were mainly influential factors for LNM ( OR =6 984 and OR =0 087, P <0 001 respectively). In multivariate analysis, nm23 expression was the independent risk factor for LNM ( =-0 8481, OR=0 181, P =0 0001), while p53 expression exhibited highly trend toward metastasis( =0 3150, OR=2 284, P =0 0565). None of the other clinic pathological parameters had significant effect on LNM. The significant negative correlation was found between p53 and nm23 expression (r s=-0 3849, P =0 0003), which played combined role in LNM. Conclusion The p53 and nm23 co expression may be useful markers for predicting of tumor metastatic risk and poor prognosis in the patients with ESCC.