Fu C G, Tominaga O, Nagawa H, Nita M E, Masaki T, Ishimaru G, Higuchi Y, Tsuruo T, Muto T
Department of Colorectal Surgery, Changhai Hospital, Second Military Medical University, Shanghai, People's Republic of China.
Dis Colon Rectum. 1998 Jan;41(1):68-74. doi: 10.1007/BF02236898.
Recent studies showed that p53 and p21 may play major roles in determining tumor radiosensitivity through the apoptosis pathway. The aim of this study was to investigate the predicting value of radiosensitivity in human rectal carcinoma.
p53 and p21/WAF1 expressions in formalin fixed, paraffin-embedded, preradiation biopsy samples from 49 patients with primary rectal carcinoma were analyzed immunohistochemically. p53 and p21 expressions and their relationships with histopathologic changes after radiation and other clinical features were evaluated.
Expressions of p53 and p21/WAF1 were 49 and 28.6 percent, respectively. In 36.7 percent of total tumors, significant histopathologic effect can be observed. There was a significant inverse expression of p53 and p21. Most of the p53(+) or p21(-) tumors were radioresistant, and the majority of p53(-) or p21(+) tumors were radiosensitive. Tumors size in the radiosensitive, p53(-), or p21(+) group decreased more significantly than in radioresistant, p53(+), or p21(-) group (P < 0.01), and patients with radioresistant, p53(+), or p21(-) tumors had more local recurrence, more distant metastasis, and a shorter five-year survival rate than those with radiosensitive, p53(-), or p21(+) tumors, but without statistic significance. No statistically significant correlation can be observed between other tumor clinical features and radiosensitivity, p53, or p21 expressions.
Immunohistochemistry detection of p53 and p21 expressions may be useful parameters for more radiosensitive patients selected for preoperative radiotherapy.
近期研究表明，p53和p21可能在通过凋亡途径决定肿瘤放射敏感性方面发挥主要作用。本研究旨在探讨其对人类直肠癌放射敏感性的预测价值。
对49例原发性直肠癌患者放疗前经福尔马林固定、石蜡包埋的活检样本进行免疫组织化学分析，检测p53和p21/WAF1的表达情况。评估p53和p21的表达及其与放疗后组织病理学变化和其他临床特征的关系。
p53和p21/WAF1的表达率分别为49%和28.6%。在所有肿瘤中，36.7%可观察到明显的组织病理学效应。p53和p21呈显著负表达。大多数p53(+)或p21(-)的肿瘤具有放射抗性，而大多数p53(-)或p21(+)的肿瘤具有放射敏感性。放射敏感组、p53(-)组或p21(+)组的肿瘤大小较放射抗性组、p53(+)组或p21(-)组减小更显著（P<0.01），且放射抗性组、p53(+)组或p21(-)肿瘤患者的局部复发更多、远处转移更多，五年生存率低于放射敏感组、p53(-)组或p21(+)肿瘤患者，但差异无统计学意义。未观察到其他肿瘤临床特征与放射敏感性、p53或p21表达之间存在统计学显著相关性。
免疫组织化学检测p53和p21的表达可能是选择术前放疗更敏感患者的有用参数。
