Sugo H, Takamori S, Kojima K, Beppu T, Futagawa S
Second Department of Surgery, Juntendo University, School of Medicine, Tokyo, Japan.
Surg Today. 1999;29(9):849-55. doi: 10.1007/BF02482774.
The significance of p53 mutations in the primary lesion for recurrent hepatocellular carcinoma (HCC) was evaluated. Mutations of p53 were examined using nonradioisotopic (nonRI)-polymerase chain reaction (PCR)-single strand conformation polymorphism (SSCP) in 98 resected HCCs. Of the 98 cases, 25 (26%) had a p53 mutation. In 83 patients who survived surgery, the presence of a p53 mutation was associated with a shortened overall survival (P < 0.001) and a shortened cancer-free survival (P < 0.05). In 43 patients who developed recurrence, there was no statistically significant correlation between the status of p53 in the primary lesion and the clinical features of recurrent HCCs examined, i.e., extrahepatic metastasis, the number of recurrent tumors, extent of recurrent tumors, and treatment for recurrent tumors. However, postrecurrence survival was significantly lower in patients in whom a p53 mutation had been detected in the primary lesion (P < 0.01). A multivariate analysis for prognostic value after recurrence revealed that the p53 mutation was a useful independent prognostic factor affecting survival after recurrence (P < 0.01). In conclusion, our findings suggest that HCCs with p53 mutations have a high malignant potential based on their poor prognosis. Therefore, a p53 mutation in the primary lesion is useful as an indicator of the biological behavior of recurrent HCCs.
评估了原发性病变中p53突变对复发性肝细胞癌（HCC）的意义。采用非放射性（nonRI）-聚合酶链反应（PCR）-单链构象多态性（SSCP）检测了98例手术切除的HCC中的p53突变。98例病例中，25例（26%）存在p53突变。在83例术后存活的患者中，p53突变的存在与总生存期缩短（P<0.001）和无癌生存期缩短（P<0.05）相关。在43例出现复发的患者中，原发性病变中p53的状态与所检测的复发性HCC的临床特征，即肝外转移、复发肿瘤数量、复发肿瘤范围和复发肿瘤治疗之间无统计学显著相关性。然而，原发性病变中检测到p53突变的患者复发后的生存期显著较低（P<0.01）。对复发后预后价值的多因素分析显示，p53突变是影响复发后生存的一个有用的独立预后因素（P<0.01）。总之，我们的研究结果表明，具有p53突变的HCC因其预后不良而具有较高的恶性潜能。因此，原发性病变中的p53突变可作为复发性HCC生物学行为的一个指标。
