Kobayashi S, Koide Y, Endo M, Isono K, Ochiai T
Second Department of Surgery, Chiba University School of Medicine, Japan.
Am J Surg. 1999 Jun;177(6):497-502. doi: 10.1016/s0002-9610(99)00085-9.
The p53 gene alteration is identified in approximately half of all human tumors, and is now thought to be a key gene for regulating the cell cycle through the induction of p21(WAF1/CIP1) and inducing apoptosis through some genes such as BAX. In this study, we investigated the prognostic value of p53 mutation for postoperative esophageal squamous cell carcinoma patients.
The subjects studied were 42 esophageal squamous cell carcinoma patients who underwent esophagectomy with complete curability in our department. The cases were limited to stage II and III. DNA was extracted from paraffin-embedded tissues. A p53 gene mutation was detected by polymerase chain reaction-single strand conformation polymorphism and subsequent direct sequencing method for exons 5 to 9. The 5-year survival rate was calculated and statistically compared between the p53 mutation(+) and (-) groups by the log rank test.
The p53 gene mutation was identified in 14 cases (33.3%). The 5-year survival rate of the p53 mutation(-) group (n = 28) was significantly higher than the (+) group (n = 14; 51.0% versus 35.7%, P <0.05 by the log rank test). Recurrence could be identified in 10 of 14 p53 mutation(+) cases (71.4%), whereas it was found in 12 of 28 (-) cases (42.8%).
The current study indicated that p53 mutation of tumor tissues might be a prognostic factor for esophageal squamous cell carcinoma cases and one of the risk factors for its recurrence.
p53基因改变在大约一半的人类肿瘤中被发现，目前被认为是通过诱导p21（WAF1/CIP1）来调节细胞周期以及通过一些基因（如BAX）诱导细胞凋亡的关键基因。在本研究中，我们调查了p53突变对术后食管鳞状细胞癌患者的预后价值。
研究对象为42例在我科接受了根治性食管切除术的食管鳞状细胞癌患者。病例限于II期和III期。从石蜡包埋组织中提取DNA。通过聚合酶链反应-单链构象多态性及随后的外显子5至9直接测序法检测p53基因突变。计算5年生存率，并通过对数秩检验对p53突变（+）组和（-）组进行统计学比较。
14例（33.3%）检测到p53基因突变。p53突变（-）组（n = 28）的5年生存率显著高于（+）组（n = 14；51.0%对35.7%，对数秩检验P<0.05）。14例p53突变（+）病例中有10例（71.4%）出现复发，而28例（-）病例中有12例（42.8%）出现复发。
当前研究表明，肿瘤组织的p53突变可能是食管鳞状细胞癌病例的一个预后因素，也是其复发的危险因素之一。
