Wang Peng, Liang Jianwei, Wang Zheng, Hou Huirong, Shi Lei, Zhou Zhixiang
1 Department of Colorectal Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
2 The Overall Planning Office, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Tumour Biol. 2017 May;39(5):1010428317703651. doi: 10.1177/1010428317703651.
This retrospective cohort study aimed to discuss the prognostic value of p53 positive in colorectal cancer. A total of 124 consecutive patients diagnosed with colorectal cancer were evaluated at the National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from 1 January 2009 to 31 December 2010. The expression of p53 in colorectal cancer was examined by immunohistochemistry. Based on the expression levels of p53, the 124 patients were divided into a p53 positive group and a p53 negative group. In this study, 72 patients were in the p53 positive group and 52 in the p53 negative group. The two groups were well balanced in gender, age, body mass index, American Society of Anesthesiologists scores, and number of lymph nodes harvested. p53 positive was associated with carcinoembryonic antigen ≥5 ng/mL ( p = 0.036), gross type ( p = 0.037), degree of tumor differentiation ( p = 0.026), pathological tumor stage ( p = 0.019), pathological node stage ( p = 0.004), pathological tumor-node-metastasis stage ( p = 0.017), nerve invasion ( p = 0.008), and vessel invasion ( p = 0.018). Tumor site, tumor size, and pathological pattern were not significantly different between these two groups. Disease-free survival and overall survival in the p53 positive group were significantly shorter than the p53 negative group ( p = 0.021 and 0.025, respectively). Colorectal cancer patients with p53 positive tended to be related to a higher degree of malignancy, advanced tumor-node-metastasis stage, and shorter disease-free survival and overall survival. p53 positive was independently an unfavorable prognostic marker for colorectal cancer patients.
这项回顾性队列研究旨在探讨p53阳性在结直肠癌中的预后价值。2009年1月1日至2010年12月31日期间,中国医学科学院肿瘤医院/国家癌症中心对124例连续诊断为结直肠癌的患者进行了评估。采用免疫组织化学法检测结直肠癌中p53的表达。根据p53的表达水平,将124例患者分为p53阳性组和p53阴性组。本研究中,p53阳性组72例,p53阴性组52例。两组在性别、年龄、体重指数、美国麻醉医师协会评分和清扫淋巴结数量方面均衡良好。p53阳性与癌胚抗原≥5 ng/mL(p = 0.036)、大体类型(p = 0.037)、肿瘤分化程度(p = 0.026)、病理肿瘤分期(p = 0.019)、病理淋巴结分期(p = 0.004)、病理肿瘤-淋巴结-转移分期(p = 0.017)、神经侵犯(p = 0.008)和血管侵犯(p = 0.018)相关。两组间肿瘤部位、肿瘤大小和病理类型无显著差异。p53阳性组的无病生存期和总生存期显著短于p53阴性组(分别为p = 0.021和0.025)。p53阳性的结直肠癌患者往往恶性程度较高、肿瘤-淋巴结-转移分期较晚、无病生存期和总生存期较短。p53阳性是结直肠癌患者独立的不良预后标志物。