85例非小细胞肺癌中p53基因异常的预后价值

目的：探讨ｐ５３蛋白表达和基因突变在非小细胞肺癌（ＮＳＣＬＣ）中的预后价值。方法：利用免疫组化方法检测８５例ＮＳＣＬＣ的ｐ５３蛋白表达，聚合酶链式反应－单链构象多态性（ＰＣＲ－ＳＳＣＰ）方法检测３１例肺腺癌ｐ５３基因５、６、７、８外显子突变，研究结果进行单因素生存分析。结果：本组ＮＳＣＬＣ病人的平均年龄为５５．６±８．４岁（中位数５５岁），随访时间的中位数为４７个月，３年、５年总体生存率分别为６６％和６１％。ｐ５３蛋白表达与预后无关（χ２＝１．００，Ｐ＝０．８），而ｐ５３基因突变组病人的生存率显著低于无ｐ５３基因突变组（χ２＝４．８１，Ｐ＝０．０３）。同时，ｐ５３蛋白表达与ＰＣＲ－ＳＣＰ检测的ｐ５３基因突变的一致率仅为５２％。结论：在ＮＳＣＬＣ中ｐ５３蛋白表达和基因突变可能有不同的预后意义，ｐ５３基因突变可作为肺腺癌的辅助预后指标。

The Prognostic Significance of p53 Protein Expression and Gene Mutation in Non-small Cell Lung Cancer

Objection:To study the prognostic value of p53 protein expression and gene mutation in non-small cell lung cancer(NSCLC).Methods:The expression of p53 protein was detected by immunohistochemistry method in 85 cases NSCLC and the p53 gene mutation of exon 5, exon 6, exon7, exon8 in 31 cases from lung adenocarcinoma were detected by Polymerase Chain Reaction-Single Strand Conformation Polymorphism(PCR-SSCP) method. The result of study was analyzed by univariate survival analysis.Results:The patients' mean age was 55.6±8.4 years. Median follow-up was 47 months(range from 0.5 months to 120 months). Overall 3-year survival was 66% and overall 5-year survival was 61%. The expression of p53 protein didn't correlated with prognosis of the patients from non-small cell lung cancer(χ 2=1.00, P=0.86),but survival proportion of the patients with p53 gene mutation was significantly lower than the patients without p53 gene mutation(χ 2=4.81,P=0.03).At the same time, the concordance rate was only 52%.Conclusion:The expression of p53 protein and p53 gene mutation could have different prognostic significance in NSCLC.p53 gene mutation could be adjuvant prognostic marker in lung adenocarcinoma.