Roa J C, Roa I, Melo A, Araya J C, Villaseca M A, Flores M, Schneider B
Unidad de Anatomía Patológica, Servicio y Departamento de Cirugía, Hospital de Temuco., Facultad de Medicina, Universidad de la Frontera, Temuco, Chile.
Rev Med Chil. 2000 Sep;128(9):996-1004.
Genetic events associated to colorectal carcinoma are well characterized, but there is scanty information about this issue in Chilean subjects.
To determine the frequency and distribution of exons 5, 6, 7, 8 and 9 mutations and the immunohistochemical expression of p53 gene in biopsy samples of colorectal carcinoma.
p53 gene exons 5, 6, 7, 8 and 9 were directly sequenced in 42 biopsy samples of colorectal carcinoma. Immunohistochemical expression of p53 was determined in 35 samples.
Thirty one discrete mutations (12 transitions, 11 transversions and 8 insertions) were observed in 21 samples (60%). Nine samples had mutations in exon 5, twelve samples had mutations in exon 6, seven samples had mutations in exon 7 and three samples had mutations in exons 8 and 9. Immunohistochemical expression of p53 protein was observed in 18 of 35 cases. There was a high correlation between the genetic alteration and immunohistochemistry, when p53 was expressed in more the 20% of cells. The positive and negative predictive values of p53 expression were 87 and 80% respectively. There was a non significant lower mortality among patients with mutations in their biopsies.
These results confirm the involvement of p53 gene mutations in colonic carcinogenesis. Immunohistochemical methods for the detection of p53 protein have a high predictive value.
与结直肠癌相关的基因事件已得到充分表征,但在智利人群中关于此问题的信息却很少。
确定结直肠癌活检样本中第5、6、7、8和9外显子突变的频率和分布以及p53基因的免疫组化表达情况。
对42例结直肠癌活检样本的p53基因第5、6、7、8和9外显子进行直接测序。在35个样本中测定p53的免疫组化表达。
在21个样本(60%)中观察到31个离散突变(12个转换、11个颠换和8个插入)。9个样本在第5外显子有突变,12个样本在第6外显子有突变,7个样本在第7外显子有突变,3个样本在第8和9外显子有突变。在35例中的18例观察到p53蛋白的免疫组化表达。当p53在超过20%的细胞中表达时,基因改变与免疫组化之间存在高度相关性。p53表达的阳性和阴性预测值分别为87%和80%。活检中有突变的患者死亡率略低,但差异无统计学意义。
这些结果证实了p53基因突变参与结肠癌发生。检测p53蛋白的免疫组化方法具有较高的预测价值。