p53蛋白在甲状腺乳头状癌中的表达及临床意义

目的　研究ｐ５３蛋白在甲状腺乳头状腺癌中的表达，并探讨其能否成为甲状腺乳头状腺癌的独立预后因素。方法　应用免疫组化方法，对４０例甲状腺乳头状腺癌、１０例甲状腺滤泡型腺瘤和１０例甲状腺正常组织进行了ｐ５３蛋白表达的研究，并对可能影响甲状腺乳头状腺癌病人预后的有关因素进行了ｌｏｇｒａｎｋ单因素生存分析和Ｃｏｘ逐步回归多因素生存分析。结果　７例（１７．５％）甲状腺癌的ｐ５３蛋白表达阳性，而甲状腺滤泡型腺瘤及正常组织的表达均为阴性；表达阳性的病人其术后复发率较表达阴性者明显升高，差异有显著性（Ｐ＜０．０５）；经ｌｏｇｒａｎｋ检验及Ｃｏｘ逐步回归多因素生存分析，提示ｐ５３蛋白阳性表达病人术后复发的风险比是阴性表达者的４．３２４８８倍，差异有显著性（Ｐ＜０．０５）。结论　ｐ５３蛋白在甲状腺乳头状腺癌中有一定的表达，表达阳性的病人其术后复发率较表达阴性者明显升高，ｐ５３蛋白阳性表达是甲状腺癌术后复发的预后指标。建议应加强对此类病人的治疗和随访工作。

Overexpression of p53 Protein in Papillary Thyroid Carcinoma and with its Clinical Significance

Purpose To study the overexpression of p53 protein and to evaluate whether it can be an independent prognostic factor for patients with papillary thyroid carcinoma. Methods p53 protein was measured in papillary thyroid carcinomas ( n =40),normal thyroid tissues ( n= 10) and follicular thyroid adenomas ( n =10) with an immunohistochemical staining.Statistical analysis was based on the log rank test and Cox analysis. Results We found overexpression of p53 protein in 7 cases (17.5%) among 40 papillary thyroid carcinomas.No positive expression was found in both normal thyroid specimens and follicular adenomas.The recurrence rate was clearly higher in patients with overexpression of p53 protein than in patients with low or non expression of p53 protein, P <0.05.The log rank test and Cox analysis with the forward stepwise method for overall survival suggests that p53 protein was an independent prognostic factor for papillary thyroid carcinoma. Conclusions Overexpression of p53 protein was higher in papillary thyroid carcinomas than in normal thyroid tissues and follicular adenomas,The recurrence rate was clearly higher in patients with overexpression of p53 protein than in patients with low or nonexpression of p53 protein,p53 protein was an independent prognostic factor for patients with papillary thyroid carcinoma.