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目的研究胃癌组织中p27Kip1和p53的表达与胃癌浸润、转移和预后的关系。方法用免疫组化(二步法)检测100例胃癌组织中的p27Kip1蛋白和p53蛋白的表达。结果100例胃癌组织中p27Kip1和p53蛋白阳性表达率分别为44%和49%。在胃癌深部浸润组、淋巴结转移组和5年内死亡组中p27Kip1呈显著低表达(P<0.05);在胃癌淋巴结转移组和5年内死亡组中p53呈显著高表达(P<0.05)。经单变量分析结果显示p27Kip1高表达组5年生存率为70.59%,显著高于低表达组54.55%,和阴性组26%;p53高表达组5年生存率为19.23%,显著低于低表达组43.75%和阴性组53.19%。多变量Cox回归模型分析显示p27Kip1、p53均是独立的预后指标,但p27Kip1表达对患者预后的相对危险度(RR=3.06)显著大于p53表达的相对危险度(RR=2.33,P<0.01)。结论p27Kip1低表达与p53高表达的癌细胞常更能浸润与转移,使患者生存率明显降低。p27Kip1和p53是胃癌预后的独立指标,其中p27Kip1表达评估胃癌预后的作用优于p53。
Objective To study the relationship between the expression of p27Kip1 and p53 and the infiltration, metastasis and prognosis of gastric cancer. Methods The expressions of p27Kip1 protein and p53 protein in 100 cases of gastric cancer tissues were detected by immunohistochemistry (two-step method). Results The positive rates of p27Kip1 and p53 in 100 cases of gastric carcinoma were 44% and 49% respectively. The expression of p27Kip1 was significantly lower in gastric cancer with deep infiltration group, lymph node metastasis and death within 5 years (P <0.05), and was significantly higher in lymph node metastasis group and death group within 5 years (P <0.05). The univariate analysis showed that the 5-year survival rate of p27Kip1 high expression group was 70.59%, significantly higher than that of low expression group 54.55%, and negative group 26%; 5-year survival rate of p53 high expression group was 19.23%, significantly lower than low expression Group 43.75% and negative group 53.19%. Multivariate Cox regression analysis showed that both p27Kip1 and p53 were independent predictors of prognosis. However, the relative risk of prognosis of patients with p27Kip1 expression (RR = 3.06) was significantly higher than that of p53 (RR = 2.33, P <0.01). Conclusion The low expression of p27Kip1 and the high expression of p53 in cancer cells are often more invasive and metastable, the patient survival rate was significantly lower. p27Kip1 and p53 are independent prognostic indicators of gastric cancer, of which p27Kip1 expression is superior to p53 in assessing the prognosis of gastric cancer.