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目的:研究p53和mdm2基因在肺癌中的表达,探讨其与肺癌临床特征及预后的关系;方法:采用免疫组化S—P法,检测p53和mdm2基因蛋白在70例肺癌中的表达。结果:70例肺癌中p53阳性率58.6％;mdm2阳性率52.9％:各型之间表达差异均无显著性。p53阳性表达与鳞癌淋巴结转移及分期有关;与腺癌淋巴结转移有关;与小细胞肺癌淋巴结转移及分期有关;13例正常肺组织均未见p53阳性表达。mdm2阳性表达与鳞癌肿瘤大小、分期有关;与腺癌淋巴结转移及分期有关;与小细胞肺癌分期、分级与淋巴结转移无关;13例正常肺组织中3例mdm2弱阳性表达,经统计处理与肿瘤组织表达差异显著。在各型肺癌中,p53与mdm2共同阳性表达者,生存期最短;p53与mdm2共同阴性表达者,生存期最长。采用图像分析仪测定ADA值(面密度×平均光密度)与镜下观察阳性强度对比差异结果一致。结论:在肺癌中p53与mdm2可作为判断预后的指标。p53与mdm2共同阴性表达者,提示有良好的预后。采用图像分析仪测定ADA值使免疫组化由定性研究转化为定量研究,具有推广应用前景。
Objective: To study the expression of p53 and mdm2 gene in lung cancer, and to explore the relationship between p53 and mdm2 gene and clinical characteristics and prognosis of lung cancer. Methods: Immunohistochemical S-P method was used to detect the expression of p53 and mdm2 gene in 70 lung cancer patients. Results: The positive rate of p53 in 58 cases of lung cancer was 58.6%; the positive rate of mdm2 was 52.9%: There was no significant difference in expression among the various types of lung cancer. The positive expression of p53 was related to lymph node metastasis and staging of squamous cell carcinoma, lymph node metastasis of adenocarcinoma, and lymph node metastasis and staging of small cell lung cancer. There was no positive expression of p53 in 13 normal lung tissues. The positive expression of mdm2 was related to the tumor size and staging of squamous cell carcinoma. It was related to the lymph node metastasis and staging of adenocarcinoma. It was not related to the staging, grade, and lymph node metastasis of small cell lung cancer. There were 3 cases of mdm2 weak positive expression in 13 cases of normal lung tissue. The difference in tumor tissue expression was significant. In all types of lung cancer, those with positive expression of p53 and mdm2 had the shortest survival time; those with negative expression of p53 and mdm2 had the longest survival time. The ADA value (area density × average optical density) determined by image analyzer was consistent with the observed difference in positive intensity observed by microscopy. Conclusion: p53 and mdm2 can be used as indicators of prognosis in lung cancer. The common negative expression of p53 and mdm2 showed a good prognosis. The use of image analyzer to measure ADA value makes immunohistochemistry from qualitative research into quantitative research, which has broad application prospects.