Lee W J, Shun C T, Hong R L, Wu M S, Chang K J, Chen K M
Department of Surgery, National Taiwan University Hospital, Taipei, Republic of China.
Br J Surg. 1998 Aug;85(8):1138-42. doi: 10.1046/j.1365-2168.1998.00712.x.
It has been suggested that p53 plays an important part in gastric carcinogenesis but the data remain inconclusive.
Alteration of the tumour suppressor gene p53 was prospectively investigated by immunohistochemistry in 168 primary gastric cancers.
Positive staining, indicative of gene mutations, was detected in 34 tumours (20.2 per cent). No correlation was observed between expression of p53 and various clinicopathological factors, including age, sex, tumour site, gross type, tumour size, depth of invasion, lymph node metastases, distant metastases, and tumour node metastasis stage. However, p53 overexpression was different between intestinal and diffuse type gastric cancer. Survival analysis revealed a significant survival disadvantage of p53 expression in diffuse type gastric cancer (P=0.039) but not in the intestinal type. Multivariate analysis of all 168 patients revealed that independent predictors of recurrent disease included age, invasion depth and nodal involvement but not p53 expression.
The presence of p53 overexpression may identify a subset of more aggressive tumours with a poor prognosis in diffuse type gastric cancer.
有研究表明p53在胃癌发生过程中起重要作用，但数据仍不确凿。
采用免疫组织化学方法对168例原发性胃癌患者的肿瘤抑制基因p53的改变进行前瞻性研究。
在34例肿瘤（20.2%）中检测到阳性染色，提示基因突变。未观察到p53表达与包括年龄、性别、肿瘤部位、大体类型、肿瘤大小、浸润深度、淋巴结转移、远处转移及肿瘤-淋巴结-转移分期等多种临床病理因素之间存在相关性。然而，肠型和弥漫型胃癌中p53的过表达情况不同。生存分析显示，p53表达在弥漫型胃癌中具有显著的生存劣势（P = 0.039），而在肠型胃癌中则不然。对所有168例患者进行多因素分析显示，复发疾病的独立预测因素包括年龄、浸润深度和淋巴结受累情况，而不包括p53表达。
p53过表达可能提示弥漫型胃癌中预后较差的侵袭性更强的肿瘤亚组。
