Lan Yuan-Tzu, Chang Shih-Ching, Li Anna Fen-Yau, Lin Tzu-Chen, Chen Wei-Shone, Jiang Jeng-Kai, Yang Shung-Haur, Wang Huann-Sheng, Lin Jen-Kou
Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital & National Yang-Ming University, 201 Section 2, Shih-Pai Road, Taipei 112, Taiwan.
Int J Colorectal Dis. 2007 May;22(5):499-506. doi: 10.1007/s00384-006-0194-6. Epub 2006 Oct 5.
p53 protein plays a crucial role in the pathogenesis of a large number of malignancies. In this study, our goal was to elucidate the prognostic role of p53 overexpression and its relationship to clinicopathological variables in colorectal cancer.
Between 1999 and 2004, surgical specimens of 258 patients who received surgical treatment for colorectal cancer at the Veterans General Hospital, Taipei were collected. p53 expression in tumor tissue was evaluated by immunohistochemical analysis using the human p53-specific mouse monoclonal antibody, PAb 1801.
Of the 258 patients, 97 (37.6%) had overexpression of p53 in tumor tissues. The accumulation of p53 protein in tumor tissues did not correlate with age, gender, preoperative serum carcinoembryonic antigen (CEA) level, mucin content, nodal status, and tumor stage. A statistically significant correlation was found between p53 overexpression and location of the tumor in the rectum (p=0.038). Well to moderately differentiated tumors had significantly higher frequency of p53 overexpression than poorly differentiated tumors (40.0 vs 20.0%, p=0.050). Each patient was followed up for a minimum of 2 years (median 35 months). In univariate analysis, 3-year cancer-specific survival rate was significantly higher in patients with tumor p53 overexpression (88.2%) than in patients without overexpression (log rank test, p=0.037). However, in multivariate analysis, the tumour node metastasis stage remained the most significant independent prognostic factor.
The accumulation of p53 protein might have a favorable prognostic value in colorectal cancer, but it is not an independent prognostic factor.
p53蛋白在大量恶性肿瘤的发病机制中起着关键作用。在本研究中，我们的目标是阐明p53过表达在结直肠癌中的预后作用及其与临床病理变量的关系。
1999年至2004年间，收集了258例在台北荣民总医院接受结直肠癌手术治疗患者的手术标本。使用人p53特异性小鼠单克隆抗体PAb 1801通过免疫组织化学分析评估肿瘤组织中p53的表达。
在258例患者中，97例（37.6%）肿瘤组织中存在p53过表达。肿瘤组织中p53蛋白的积累与年龄、性别、术前血清癌胚抗原（CEA）水平、黏液含量、淋巴结状态和肿瘤分期无关。p53过表达与肿瘤位于直肠的位置之间存在统计学显著相关性（p = 0.038）。高分化至中分化肿瘤的p53过表达频率显著高于低分化肿瘤（40.0%对20.0%，p = 0.050）。每位患者至少随访2年（中位时间35个月）。在单因素分析中，肿瘤p53过表达患者的3年癌症特异性生存率（88.2%）显著高于无过表达患者（对数秩检验，p = 0.037）。然而，在多因素分析中，肿瘤淋巴结转移分期仍然是最显著的独立预后因素。
p53蛋白的积累在结直肠癌中可能具有良好的预后价值，但它不是一个独立的预后因素。
