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目的:P~(53)基因突变被认为是腺瘤-腺癌序列突变中的一个重要因素,并具有预后意义。本文旨在探讨大肠癌P~(53)基因突变的临床意义及其对预后的价值。材料与方法:对手术切除的69例大肠癌分别采集癌灶组织及远切端正常大肠粘膜组织,应用PCR—SSCP法进行P~(53)基因第5~8外显子检测;另对29例患者加作,癌旁淋巴结的P~(53)基因突变检测,并与常规病理检查对比。结果:大肠癌P~(53)基因突变率为52.17%(36/69),其中第5外显子突变32例,占88.89%。P~(53)基因突变与大体类型、细胞分化及Dukes分期无明显关系。本组10例DukesB期,术后2~20个月随访发现,癌旁淋巴结P~(53)基因突变组,4例发生复发,复发率为80%(4/5),而未突变组无1例复发(0/5)。本组DukesD期14例术后经2~12个月随访,P~(53)基因无突变者2例死亡,死亡率40%(2/5例),有突变者7例死亡,死亡率77.8%(7/9例)。结论:大肠癌P~(53)基因以第5外显子突变率最高,且其突变与患者预后关系较密切,P~(53)基因突变者临床预后较差;而对于癌旁淋巴结及远切端P~53基因突变的检测可作为判别患者术后预后的一个指标。
OBJECTIVE: The P53 mutation is considered to be an important factor in adenoma-adenocarcinoma sequence mutations and has prognostic significance. This article aims to investigate the clinical significance of P53 gene mutation in colorectal cancer and its value in prognosis. Materials and Methods: 69 cases of colorectal cancer undergoing surgical resection were collected from normal colorectal mucosa tissue and the distal cut-end mucosa. PCR-SSCP method was used to detect exon 5~8 of P~(53) gene; another 29 cases. The patient was added with a P53 mutation in paracancerous lymph nodes and compared with routine pathological examination. Results: The mutation rate of P53 gene in colorectal cancer was 52.17% (36/69), among which 32 cases were exon 5 mutation, accounting for 88.89%. P53 mutation had no significant relationship with gross type, cell differentiation and Dukes stage. 10 cases of Dukes B stage and 2 to 20 months follow-up found in this group, para-cancer lymph node P ~ (53) gene mutation group, 4 cases of recurrence, the recurrence rate was 80% (4/5), and no mutation in the group One case had recurrence (0/5). In this group of 14 Dukes D stage patients were followed up for 2 to 12 months. There were 2 cases of P53 mutations, 40% mortality rate (2/5 cases), 7 cases of sudden death, 77.8 mortality rate. % (7/9 cases). Conclusion: The mutation rate of P53 gene in colorectal cancer is the highest in exon 5, and its mutation is closely related to the prognosis of patients. The prognosis of P53 mutation is poor, but it is in paraneoplastic lymph nodes and beyond. Detection of the P53 mutation in the cut-end can be used as an index to determine the prognosis of patients.