Background: P53 is a tumor protein that acts as a tumor suppressor. The mutation of P53 may cause loss of tumor suppressor functions and gain of functions favoring cellular proliferation and apoptosis inhibition. The clinical implications of the tumor protein P53 gene (TP53) mutation in lung adenocarcinoma are indefinite. The aim of this study is to explore the clinical significance of the mutant P53 protein expression in lung adenocarcinoma tissues.
Methods: The clinicopathological data of 120 lung adenocarcinoma patients who underwent surgery were retrospectively analyzed. The mutant 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.
Results: The 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.
Conclusions: Patients with lung adenocarcinoma with mutant TP53 had a poor outcome. Accordingly, the mutant P53 protein may serve as a molecular prognosis marker for lung adenocarcinoma patients.
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。