p53和VEGF在前列腺癌组织中的表达及临床意义

目的研究p53和血管内皮生长因子（vascular endothelial growthfactor,VEGF）在同一前列腺癌（prostate cancer,Pca）组织中的表达及与Pca临床参数的关系,探讨肿瘤血管形成及调节机制。方法应用免疫组织化学LDP法检测46例Pca组织及20例良性前列腺增生症（benign prostatic hyperplasia,BPH）组织中p53蛋白及VEGF的表达。结果Pca组织中p53与VEGF阳性表达率分别为41.30%（19/46）和71.74%（33/46）,均明显高于BPH组（P〈0.05）;p53与VEGF表达呈明显正相关（P〈0.05）;二者在Pca组织中的表达水平与其病理分级和临床分期均呈正相关（P〈0.05）;p53和VEGF阳性表达的肿瘤复发迅速、易转移,p53阴性而VEGF阳性表达较阴性表达者预后差。结论p53和VEGF与Pca组织学分级？恶性程度和预后密切相关,是检测Pca的较好分子标志物;Pca是典型的血管依赖性病变,p53可能通过p53-VEGF调节旁路途径促进Pca的肿瘤血管形成,联合检测p53和VEGF的表达可作为判断Pca生物学行为及预后的重要指标。

The expression of p53 and VEGF in human prostatic carcinoma and their clinical significances

Objective To study the expression of p53 and vascular endothelial growth factor(VEGF)in human prostatic carcinoma tissue and their relationship with the clinicopathological parameters,and to understand the role of p53 and VEGF in the progression of tumors.Methods The expression of p53 and VEGF in 46 cases of prostatic carcinoma and 20 cases of BPH were determined by immunohistochemical LDP methods.Results The positive expression rates of p53 and VEGF in 46 cases of Pca were 41.30% and 71.74%,respectively.The expression levels of p53 and VEGF in prostatic carcinoma were much higher than those in BPH(P<0.05);the positive correlation was noted between p53 expression and VEGF expression(P<0.05);and both of them were significantly related to the tumor pathologic grades(P<0.05)and tumor clinical stage(P<0.05).Tumors with high levels of p53 that were VEGF positive recurred earlier and had a greater risk of stage progression than those with low levels of p53 and VEGF negative.The high levels of VEGF also indicated the poorest prognosis in p53 negative tumors than those with low levels of VEGF.Conclusion This study indicates that p53 and VEGF are closely related to the histopathological grading,the tumor differentiation and prognosis of Pca.p53 and VEGF are good molecular markers of Pca.The pathological changes in the tumor are typically vessel dependent,and vascularization is favourable to tumor growth,infiltration and recurrence.Mutant-type p53 protein accumulation may be associated with tumor angiogenesis through the way of VEGF up-regulation.The combined detection of p53 and VEGF may serve as an important index to estimate the biological behavior and prognosis of Pca.