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目的:探讨肝癌和癌旁组织中P~(16)、P~(53)、P~(21)/WAF1蛋白的表达与原发性肝癌的诊断和预后的关系。方法:应用免疫组化技术检测48例手术切除肝癌及癌旁组织中肿瘤相关基因的表达。结果:P~(16)、P~(53)、P~(21)/WAF1蛋白在肿瘤组织中的阳性表达分别为39.6％、56.2％、43.7％,与癌旁组织中的表达差异有显著性(P<0.05),瘤体直径大于5cm、包膜不完整的肿瘤、生存期小于2年和伴有瘤栓的肿瘤组中,P~(21)、P(53)、P~(16)与癌旁组织的表达差异有显著性(P<0.05);在生存期大于2年和复发时间大于6个月的病例中,肿瘤组织表达P~(16)蛋白明显高于生存期小于2年和复发时间小于6个月的病例(P<0.05);在伴有瘤栓和侵润生长的肿瘤组织中P~(53)蛋白表达与不伴有瘤栓和膨胀生长的表达差异有显著性;P~(21)在低分化和早期复发的肿瘤组织中表达显著高于高分化和复发时间较晚的肿瘤组织(P<0.05)。结论:P~(53)基因突变与肝癌的分期、门静脉癌栓的形成、肿瘤的侵袭性有关,是肝癌发展的晚期事件,P~(21)与肝癌的分化和预后有关;P~(16)与肝癌的复发和预后有关。P~(16)、P~(53)、P~(21)可以作为对肝癌分化、侵袭、转移和预后进行预测的标志。
Objective: To investigate the relationship between the expression of P16, P53, P21/WAF1 protein and the diagnosis and prognosis of primary liver cancer. Methods: Immunohistochemical technique was used to detect the expression of tumor-associated genes in 48 cases of surgical resection of hepatocellular carcinoma and adjacent tissues. Results: The positive expressions of P16, P53, and P21/WAF1 protein in tumor tissues were 39.6%, 56.2%, and 43.7%, respectively. There were significant differences between the expression of P16, P53, and P21/WAF1 in tumor tissues. (P<0.05), Tumor diameter greater than 5cm, incompletely encapsulated tumors, tumors with a survival time of less than 2 years, and tumor thrombi, P21, P53, P16 There was a significant difference (P<0.05) between the expression of paracancerous tissue and the paraneoplastic tissue. In the cases with a survival period of more than 2 years and a relapse time of more than 6 months, the P16 protein expression in the tumor tissue was significantly higher than the survival period of less than 2 months. The annual and recurrence time was less than 6 months (P<0.05). There was a significant difference in the expression of P53 protein with tumor thrombus and swelled growth in tumor thrombus and infiltrating tumor tissue. The expression of P21 in poorly differentiated and early recurring tumors was significantly higher than that in well-differentiated and relapsed tumors (P<0.05). Conclusion: P53 mutation is related to the stage of liver cancer, the formation of portal vein tumor thrombus, and the invasion of tumor. It is a late event of the development of liver cancer. P21 is related to the differentiation and prognosis of liver cancer. P16 ) is related to the recurrence and prognosis of liver cancer. P16, P53, and P21 can be used as markers to predict the differentiation, invasion, metastasis, and prognosis of HCC.