卵巢肿瘤中癌基因 nm23Hl,c-erbB-2,ras 和 p53 的蛋白表达与腹膜后淋巴结转移关系的研究

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目的本研究旨在结合腹膜后淋巴结切除术,探讨癌蛋白nm23H1,p185,p21,p53在卵巢癌中的表达与卵巢癌腹膜后淋巴转移(LNM)的关系。方法采用免疫组化方法测定石腊包埋标本中nm23H1,p185,p21和p53的表达,单因素、多因素分析它们的表达与淋巴结转移关系。结果在31例(31.6%)患者中nm23H1蛋白表达阳性;p21的表达与组织分化程度及残留癌相关。病理证实49例(55.1%)有淋巴结转移;nm23H1蛋白表达阳性的LNM率低(35.7%vs63.9%,P=0.012);p21表达与LNM正相关(P<0.001);p185(~)病例LNM率(64.4%)高于p185(+)或p185(-)的转移率(45.9%),但差异无统计学意义;p53表达与LNM无关。与LNM相关的临床因素是伴有腹水、组织分化不良、残留灶和分期晚。经Logistic回归多因素分析,影响淋巴结转移的独立危险因素是nm23H1蛋白阴性表达,p21的阳性表达、有残留灶和分化差。结论在卵巢恶性肿瘤中,nm23H1蛋白和p21的表达对腹膜后淋巴结转移有独立的联合作用,而p185和p53的表达则无关。 Objective To investigate the relationship between the expression of oncoproteins nm23H1, p185, p21 and p53 in ovarian cancer and retroperitoneal lymphatic metastasis (LNM) in ovarian cancer in combination with retroperitoneal lymph node dissection. Methods Immunohistochemistry was used to detect the expression of nm23H1, p185, p21 and p53 in paraffin embedded specimens. The relationship between them was analyzed by multivariate and multi-factor analysis. Results The positive expression of nm23H1 was found in 31 patients (31.6%). The expression of p21 was correlated with the degree of tissue differentiation and residual cancer. The lymph node metastasis was confirmed in 49 cases (55.1%) with pathological examination. The LNM positive rate of nm23H1 protein was low (35.7% vs 63.9%, P = 0.012). The positive correlation between p21 expression and LNM was found (P <0.05). 001). The LNM rate (64.4%) in p185 ( ~ ) cases was higher than that in p185 (+) or p185 (-) cases (45.9%), but the difference was not statistically significant. Nothing to do Clinical factors associated with LNM are associated with ascites, poor tissue differentiation, residual foci and staging. Logistic regression multivariate analysis showed that the independent risk factors of lymph node metastasis were negative expression of nm23H1 protein, positive expression of p21, residual tumor and poor differentiation. Conclusion The expression of nm23H1 protein and p21 in ovarian cancer has an independent effect on the metastasis of retroperitoneal lymph node. However, the expression of p185 and p53 has no correlation.
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