摘要
目的探讨p53、p21^Gip1/WAF1和Gadd45α在乳腺癌中的表达情况及其与临床病理参数和预后的关系。方法采用组织芯片和免疫组化sP法检测133例乳腺癌组织及其癌旁正常组织中p53、p21^Gip1/WAF1和Gadd45α的表达，应用Spearman秩和相关分析两者之间的相关性，应用Kaplan．Meier法和Cox多因素回归模型分析与预后的关系。结果p53、p21^Gip1/WAF1和Gadd45α在乳腺癌组织中的阳性表达率（58．6％和47．4％）高于正常乳腺组织（O％）（P〈0．05）；Gadd45et在乳腺癌组织中的阳性表达率（41．4％）低于正常乳腺组织（P〈0．05）。v53与淋巴结转移、临床分期相关，差异均有统计学意义（均P〈0．05），p53、p21^Gip1/WAF1与组织分化程度、局部复发、C—erbB-2状态相关，Gadd45a与组织分化程度、腋窝淋巴结转移、远处转移组、ER／PR阳性状态相关。等级相关分析结果提示p53、p21^Gip1/WAF1表达与p53表达呈正相关，Gadd45a表达与p53表达呈负相关，p53、p21^Gip1/WAF1表达与Gadd45ct表达无相关性。结合随访资料，Kaplan．Meier分析显示p53、p21^Gip1/WAF1、Gadd45a、p53、淋巴结转移、C—erbB-2、TNM分期与预后相关，Cox多因素回归分析提示p53、p21^Gip1/WAF1、C—erbB-2、TNM分期是独立的预后参数，Kaplan-Meier分析提示p53、p21^Gip1/WAF1和p53（＋）Gadd45ct（-）与乳腺癌不良预后相关。结论p53、p21^Gip1/WAF1和Gadd45α的表达与乳腺癌的病理参数及预后相关，p53（＋）Gadd45ct（-）和p53、p21^Gip1/WAF1（＋）可作为独立的预后参数。
Objeαive To explore the expression and significance of p53, p21 Cip1/WAF1 and Gadd45α protein in breast cancer and their correlations with clinicopathologic features and prognosis in breast cancer. Methods The expressions of p53, p21cip1/WAFI and Gadd45a proteins were determined by immunohistochemical staining. The relationship between these three proteins and clinicopathologic features in breast cancer was analyzed by X2 test and Spearman＇s rank correlation analysis. And the survival analyses were performed with the Kaplan-Meier method and Cox regression. The differences between the curves were examined with the two-tailed Log-rank test. Results In 133 cases of invasive breast cancer, the positive rates of p53, p21cipl/WAFI and Gadd45a protein were 58. 6% , 47.4% and 41.4% respeαively. The expressions of p21clpl/wAFI and p53 in cancer were significantly higher than those in the adjacent mammary gland tissue （P 〈 0. 05） while the expression of Gadd45oL was lower than that in the control mammary gland tissue （P 〈 0.05）. The positive rate of p21cIPl/wAn was correlated with the histological stage, local recurrence and positive C-erbB-2. And the positive rate of Gadd45α was correlated with the histological stage, lymph node metastasis, metastasis and positive estrogen receptor/progesterone receptor （ER/PR）. The positive rate of p53 was correlated with the lymph node metastasis and TNM stage. Spearman＇s rank correlation analysis showed that p21Cipl/WAF1 was correlated positively with p53, p53 negatively with Gadd45a while p21cip1/wAF1 had no correlation with Gadd45a. With the follow-up data, Kaplan-Meier analysis showed that p21Cip1/WAF1, Gadd45α, p53, lymph node metastasis, C-erbB-2 positive and TMN stage were associated with prognosis. Furthermore, Cox stepwise hazard analysis shows that p2lcip1/wAvl, Gadd45α, C-erbB-2 and TMN stage were correlated with prognosis of breast cancer. Also the Kaplan-Meier analysis showed that p53 （ ＋ ） Gadd45a （ - ） and p53 （ ＋ ） p21cip1/wAF1 �
出处
《中华医学杂志》
CAS
CSCD
北大核心
2012年第34期2389-2393,共5页
National Medical Journal of China
