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目的 了解p5 3基因及其蛋白在结肠癌发生、转移过程中的动态变化以及p5 3变异与生存期的关系。方法 p5 3基因exon 5 - 9以DGGE及自动DNA序列分析来检测。结果 41例大肠癌病人中 ,2 6例呈p5 3变异 (6 3% ) ,其中 6例仅在肝转移灶发现p5 3变异 ,其余均为原发灶、转移灶一致性的变异。另有 3例原发灶即有p5 3变异的病人 ,在转移灶出现了新增加的变异。生存分析显示 ,在肝转移灶含变异型p5 3的病人比含野生型P5 3者具有更长的术后生存期。结论 在结肠癌肝转移过程中 ,p5 3变异主要开始于肠癌原发灶 ,并被保持于转移至肝脏的癌细胞内 ,小部分p5 3变异也可以始发于转移灶。对于实施肝部分切除术的病人 ,术后生存期在转移癌灶含变异型p5 3者长于含野生型p5 3者。
Objective To investigate the dynamic changes of p5 3 gene and its protein during the carcinogenesis and metastasis of colon carcinoma and the relationship between p5 3 mutation and survival. Methods The p5 3 gene exon 5 - 9 was tested by DGGE and automated DNA sequence analysis. Results Among the 41 cases of colorectal cancer, 26 cases showed p5 3 mutation (6 3%), of which 6 cases only found p5 3 mutation in liver metastasis. The rest were the variation of primary tumor and the consistency of metastasis. Another 3 cases of primary tumor that is p5 3 mutation in patients with metastasis showed a new increase in variation. Survival analysis showed that patients with variant p53 in liver metastases had longer postoperative survival than those with wild-type P53. Conclusion In the process of hepatic metastasis of colon cancer, the mutation of p5 3 mainly begins in the primary tumor of the intestine and is retained in the cancer cells transferred to the liver. A small part of the mutation of p5 3 may also originate in the metastasis. For patients undergoing partial hepatectomy, postoperative survival in metastatic lesions containing mutant p5 3 were longer than wild type p5 3.