伴神经内分泌分化结直肠腺癌中p53、Ki-67的表达及其与预后的关系

目的：探讨伴神经内分泌分化（NED）结直肠腺癌中p53、Ki-67的表达及其与预后的关系。方法采用SP法检测NSE、CgA、Syn、CD-57及p53、Ki-67蛋白在65例结直肠腺癌组织中的表达,分为NED阳性组35例和NED阴性组30例,并分析p53、Ki-67表达对预后的影响。结果 NED阳性组中p53、Ki-67阳性表达率均明显高于NED阴性组（P〈0.05）。p53、Ki-67的表达与淋巴结转移、组织学分化和DUCK分期密切相关（P〈0.05）。NED阴性组的5年生存率明显高于NED阳性组（P〈0.05）；NED阳性组中,p53表达阴性者和Ki-67表达阴性者的5年生存率明显高于两者表达阳性者（P〈0.05）。 Cox回归分析表明,淋巴结转移、DUCK分期、p53及Ki-67表达是患者5年生存率的独立预后因素（P〈0.05）。结论 p53、Ki-67的高表达可能在伴NED结直肠腺癌发生发展过程中起重要作用；两者均为伴NED结直肠腺癌预后的独立危险因素。

The expression of p53,Ki-67 in colorectal adenocarcinoma with neuroen-docrine differentiation and the correlation between the expression and its prognosis

Objective To investigate the expression of p53, Ki-67 in colorectal adenocarcinoma with neuroendocrine differentiation （NED）, and to explore the correlation between the expression and its prognosis. Methods The expression of NSE, CgA, Syn, CD-57, p53, Ki-67 in 65 colorectal adenocarcinoma were determined by using immunohistochemi-cal staining. According the neuroendocrine index, 65 cases were divided into two groups,NED positive group（35 cases） and NED negative group （30 cases）,and analyzed the influence of erpression of p53, ki-67cm prognosis. Results The positive expression rates of p53, Ki-67 in NED positive group were higher than those in NED negative group （P〈0.05）. The expression of p53,Ki-67 in NED positive group were significantly associated with lymph node metastasis, differen-tiation and DUCK stages （P〈0.05）. The 5-year survival rate of NED negative group was obviously higher than that of NED positive group （P〈0.05）;In NED positive group, the 5-year survival rate of p53 negative and Ki-67 negative ex-pression were significantly higher than that of p53 positive and Ki-67 positive expression （P〈0.05）. Using Cox regres-sion, lymph node metastasis, differentiation, DUCK stages and the expression of p53,Ki-67 were strong independent prognostic factors for five years of disease-free survival rate of colorectal adenocarcinoma with NED patients （P〈0.05）. Conclusion The high expression of p53, Ki-67 may be associated with colorectal adenocarcinoma with NED and play an important role in malignant proliferation. p53,Ki-67 are valuable prognostic factors for colorectal adenocarcinoma with NED patients.