P53和MDM2蛋白表达对肝细胞肝癌预后判断的意义

目的 :研究肝细胞肝癌中突变型P5 3和MDM2蛋白的表达对临床预后判断的意义。方法 :应用免疫组织化学方法 ,检测 72例原发性肝细胞肝癌手术切除标本突变型P5 3、MDM2蛋白的表达 ;与临床病理学指标和术后生存期进行分析比较。结果 :突变型P5 3蛋白阳性 2 8例(38 89% ) ,MDM2蛋白阳性 2 3例 (31 94 % ) ,二者阳性表达有相关性 (r =0 2 4 8,P <0 0 5 )。突变型P5 3、MDM2蛋白阳性表达病例生存率明显低于突变型P5 3、MDM2蛋白阴性表达病例 (P <0 0 1)。突变型P5 3和MDM2蛋白表达均阳性病例 13例 (18 0 6 % ) ,中位生存期的生存率最低。单因素及多因素分析显示 ,突变型P5 3蛋白表达、MDM2蛋白表达、肿瘤大小与中位生存期的生存率有关 ,MDM2是统计学上最有意义的独立预后指标 (P <0 0 0 0 1)。结论 :应用免疫组织化学方法检测突变型P5 3和MDM2蛋白的表达可作为原发性肝细胞肝癌预后判断的指标。

Prognostic value of P53 and MDM2 protein expression in hepatocellular carcinoma

To study the prognostic value of P53 and MDM2 protein expression in patients of hepatocellular carcinoma (HCC). Methods: Samples of 72 cases of HCC were detected by immunohistochemical technique with SP, using the specific monoclonal antibodies against anti-P53 proteins and anti-MDM2. In 72 patients, the patients who had mutant P53 expression and MDM2 were compared with the other patients who had no mutant P53 expression and no MDM2 for clinicopathological paramenters and survival. Results: The frequencies of P53 and MDM2 positivity in HCC cells were 38.89% (28/72) and 31.94% (23/72), respectively. Expression of MDM2 showed a significantly positive correlation with expression of mutant P53 (r=0.248, P<0.05). Patients with positive expression of mutant P53 or protein MDM2 had poorer prognosis than patients with negative mutant P53 or protein MDM2 protein expression. Moreover, patients with both positive expression of mutant P53 or protein MDM2 (13/72, 18.06%) had the most poor prognosis than other patients with negative mutant P53 or protein MDM2 protein expression. According to Cox,s hazards analysis, univariate and multivariate analysis showed that positive expression of mutant P53 or protein MDM2 protein, and HCC sizes were significant determinants of patients, overall survival. MDM2 expression was the most useful independent factor for patients, overall survival (P<(0.000 1)). Conclusion:Detected immunohistochemically, mutant P53 or protein MDM23 protein overexpression may be used as the useful predictor of poor prognosis in patients with HCC.