摘要
目的研究P53和鼠双微基因4(MDM4)在非小细胞肺癌中的表达及其对预后的影响。方法应用免疫组织化学的方法检测MDM4和P53在非小细胞肺癌中的表达情况并做预后分析。结果单因素分析结果显示P53表达与T分期及肿瘤分化程度存在关联,MDM4只与肿瘤分化程度存在关联(P<0.05)。生存分析显示P53和MDM4都是预后危险因素(P<0.05),P53和MDM4同时阴性组的术后生存明显优于P53阳性组、MDM4阳性组及P53和MDM4同时阳性组,后三组之间无病生存率(DFS)和总生存率(OS)差异无统计学意义(P>0.05)。将后三组合并为P53和MDM4非同时阴性组是预后独立危险因素,HR为2.961(95%CI:1.522~5.067)。进一步基于TNM分期的分层分析显示无论早期还是中期患者,P53联合MDM4均具有良好预后预测作用。结论P53和MDM4阳性是非小细胞肺癌患者预后不良的危险因素,并且联合TNM分期后可能会提高预后评估准确性。
Objective To investigate the expressions of P53 and MDM4 in non-small cell lung cancer(NSCLC)and their influence on prognosis.Methods The expression levels of P53 and MDM4 in NSCLC were detected by using the immunohistochemical method and the prognosis analysis was performed.Results The single factor analysis results showed that the expression of P53 was related to the T stage and tumor differentiation,while MDM4 was only related to the differentiation degree of tumor(P<0.05).The survival analysis revealed that both P53 and MDM4 were the risk factors of prognosis(P<0.05).The postoperative survival in the both P53 and MDM4 negative group was significantly superior to the P53 positive group,MDM4 positive group and both P53 and MDM4 positive group.The disease free survival(DFS)and overall survival(OS)had no statistical difference among the latter three groups(P>0.05).The P53 and MDM4 non-simultaneous negative group merged by the latter three groups was the independent risk factor of prognosis,HR was 2.961(95%CI:1.522-5.067).The further stratification analysis based on the TNM staging showed that no matter in the patients with early stage or middle stage,P53 combined with MDM4 could have better predictive effect.Conclusion P53 and MDM4 positive is the risk factor of prognosis in the patients with NSCLC.Their combination with TNM staging may increase the accuracy of prognosis evaluation.
作者
张俊杰
郝李刚
邸永辉
齐正
李强
ZHANG Junjie;HAO Ligang;DI Yonghui;QI Zheng;LI Qiang(CT and MR Room,Xingtai Municipal First Hospital,Xingtai,Hebei 054000,China;Department of Thoracic Surgery,Xingtai Municipal People′s Hospital,Xingtai,Hebei 054000,China)
出处
《重庆医学》
CAS
2020年第8期1259-1264,共6页
Chongqing medicine
基金
河北省重点研发计划项目(18277778D)。
