p53蛋白与肝细胞癌临床病理特征及预后的关系

目的 探讨p53蛋白表达与肝细胞癌的临床病理特征及预后的关系，为术后综合治疗及判断预后提供依据。方法 采用免疫组织化学方法检测88例肝细胞癌组织中p53蛋白的表达，比较阳性患者和阴性患者的临床病理因素和术后累积复发率、术后累积生存率的差异。结果 p53蛋白表达阳性组1、2、3累积生存率分别为75．0％、54.4%、24．2％，阴性组相应的分别为84．3％、77．8％、56．1％。与阴性组相比，p53蛋白阳性组有较高的术前AFP浓度（P=0．005）、有较大的肿瘤最大直径（P=0．042）、肿瘤包膜不完整或无包膜者多见（P=0．023）。结论 p53蛋白是评价肝细胞癌恶性程度及预后的一个有价值的生物学指标。

The Expression of p53 Protein and its Relationship with Clinical Pathological Feature and Prognosis in Hepatocellular Carcinoma

Objective To investigate the expression of p53 protein in hepatocellular carcinoma （HCC） and its relationship with clinical pathological feature and prognosis of HCC and to provide the reference for the postoperative comprehensive therapy and the judgment of prognosis. Methods The expression of p53 protein in 88 specimens of HCC was detected by immunohistochemical S-P method. It was divided into two groups： the group of p53 protein positive and the group of p53 portein negative. The clinical pathological factors, postoperative cu- mulative relapse frequencies and postoperative cumulative survival rates were compared between 2 groups. Results The postoperative cumulative survival rate of 1,2,3 years in the group of p53 protein positive was75.0% ,54.4%,24.2%, respectively. In the group of p53 protein negative it was 84.3 %, 77.8 %, 56.1%, respectively. The difference of postoperative cumulative survival rate between 2 groups had statistically significance （x^2 = 4.032, P = 0.045）. Compared with the group of p53 protein negative, the group of p53 protein positive had higher preoperative AFP level （P = 0.005） and larger tumor maximum diameter （P = 0.042）. Cases of patients with imcomplete or absent tumor capsular formation in the group of p53 protein positive were more than the group of p53 protein negative （P = 0.023）. Conclusion p53 gene can be regarded as a valuable biological indication to evaluate the malignant degree and prognosis of HCC. The expression of p53 protein positive in HCC is closely related to preoperative AFP level, tumor maximum diameter, tumor capsular formation, postoperative recurrence and postoperative prognosis.