CAJ | 학술논문

背景与目的突变型TP53基因不仅丧失了抑癌功能，其编码的突变型P53蛋白还能获得促进细胞增殖、抑制细胞凋亡等功能。目前TP53基因在肺腺癌中突变的临床意义尚不十分明确。本研究旨在探讨突变型P53蛋白在肺腺癌组织中的表达及其临床意义。方法回顾性分析120例肺腺癌手术患者的临床病理资料，应用免疫组化法检测患者组织标本中突变型P53蛋白的表达，采用χ2检验分析突变型P53蛋白表达与各临床病理参数的关系，采用单因素生存分析及多因素生存分析法分析突变型P53蛋白表达与总生存期的关系。结果突变型P53蛋白在肺腺癌组织中的表达率为63.7%，突变型P53蛋白的表达与肿瘤大小（P=0.041）及病理分期（P=0.025）有关。单因素生存分析提示肿瘤大小（P=0.031）、淋巴结转移（P<0.001）、病理分期（P<0.001）以及突变型P53蛋白的表达（P=0.038）与患者总生存期密切相关。多因素生存分析提示仅有淋巴结转移（P=0.014）是患者总生存期的独立影响因素。结论TP53基因突变的肺腺癌患者预后较差，突变型P53蛋白可以作为预测患者预后的分子标志物。
배경여목적돌변형TP53기인불부상실료억암공능，기편마적돌변형P53단백환능획득촉진세포증식、억제세포조망등공능。목전TP53기인재폐선암중돌변적림상의의상불십분명학。본연구지재탐토돌변형P53단백재폐선암조직중적표체급기림상의의。방법회고성분석120례폐선암수술환자적림상병리자료，응용면역조화법검측환자조직표본중돌변형P53단백적표체，채용χ2검험분석돌변형P53단백표체여각림상병리삼수적관계，채용단인소생존분석급다인소생존분석법분석돌변형P53단백표체여총생존기적관계。결과돌변형P53단백재폐선암조직중적표체솔위63.7%，돌변형P53단백적표체여종류대소（P=0.041）급병리분기（P=0.025）유관。단인소생존분석제시종류대소（P=0.031）、림파결전이（P<0.001）、병리분기（P<0.001）이급돌변형P53단백적표체（P=0.038）여환자총생존기밀절상관。다인소생존분석제시부유림파결전이（P=0.014）시환자총생존기적독립영향인소。결론TP53기인돌변적폐선암환자예후교차，돌변형P53단백가이작위예측환자예후적분자표지물。
Background and objective P53 is a tumor protein that acts as a tumor suppressor. Te mutation of P53 may cause loss of tumor suppressor functions and gain of functions favoring cellular proliferation and apoptosis inhibition. Te clinical implications of the tumor protein P53 gene (TP53) mutation in lung adenocarcinoma are indefinite. Te aim of this study is to explore the clinical significance of the mutant P53 protein expression in lung adenocarcinoma tissues. Methods Te clinicopathological data of 120 lung adenocarcinoma patients who underwent surgery were retrospectively analyzed. Te mu-tant P53 protein expression was detected using the immunohistochemical method. Furthermore, the relationship between the mutant P53 expression and the clinicopathological parameters was analyzed using the Chi-square test, whereas that between the mutant P53 expression and overall survival was estimated using the Kaplan-Meier method and Cox regression model. Re-sults Te mutant P53 protein expression rate was 63.3%. Accordingly, the mutant P53 expression was significantly associated with tumor size (P=0.041) and clinicopathological stage (P=0.025). On the one hand, a univariate survival analysis showed that tumor size (P=0.031), lymph node metastasis (P<0.001), clinicopathological stage (P<0.001), and mutant P53 expression (P=0.038) were associated with overall survival. On the other hand, a multivariate survival analysis showed that lymph node metastasis (P=0.014) was an independent poor prognostic factor for overall survival. Conclusion Patients with lung adeno-carcinoma with mutant TP53 had a poor outcome. Accordingly, the mutant P53 protein may serve as a molecular prognosis marker for lung adenocarcinoma patients.