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目的 评价肝细胞癌p5 3蛋白表达在经导管动脉化疗栓塞 (transcatheterarterialchemoembolization ,TACE)中的作用。方法 经手术病理证实的肝细胞癌 13 6例 ,其中行 1～ 5次TACE后Ⅱ期手术切除 79例 (TACE组 ) ,按治疗方式不同分 4组 ,A组 ,仅灌注化疗药物 11例 ,治疗 1～ 4次 ;B组 ,化疗药加碘化油栓塞 3 3例 ,治疗 1～ 5次 ;C组 ,化疗药加碘化油加明胶海绵颗粒栓塞 2 3例 ,治疗 1～ 3次 ;D组 ,化疗药加碘化油、无水乙醇、明胶海绵颗粒栓塞 12例 ,治疗 1～ 3次。单纯手术 5 7例 (非TACE组 )。用TUNEL法检测AI ,用免疫组化检测各标本Bcl -2 ,Bax ,p5 3 ,Ki-67和PCNA蛋白表达。结果 梁索型、透明细胞型p5 3蛋白表达显著低于假腺样型、实体型、低分化或未分化型、硬化型 ( P <0 0 5 ) ;随着病理分级的增高 ,p5 3蛋白表达也逐渐增多 ( P <0 0 5 ) ;p5 3蛋白表达与PCNA和Ki-67蛋白表达显著正相关 (P <0 0 5 ) ,与AI ,Bcl-2 /Bax蛋白表达率显著负相关 (P <0 0 5 )。p5 3蛋白表达A组显著高于B、C、D组和单纯手术组 ;B组显著高于C和D组 ;D组显著低于单纯手术组 (P <0 0 5 )。结论 在肝细胞癌化疗栓塞中p5 3蛋白表达起增强癌细胞增殖、抑制细胞凋亡的作用
Objective To evaluate the role of p5 3 protein expression in hepatocellular carcinoma (TACE) in transcatheter arterial chemoembolization (TACE). Methods Totally 13 6 hepatocellular carcinomas confirmed by surgery and pathology were performed. One to five TACE patients underwent surgical resection in 79 cases (TACE group). The patients were divided into 4 groups according to the treatment methods. Group A received chemotherapy with only 11 drugs, The patients in group B received 33 cases of chemotherapy with iodized oil embolization for 1 to 5 times. Group C received chemotherapy with iodized oil plus gelatin sponge particles in 23 cases for 1 to 3 times. Group D, chemotherapy drugs plus iodized oil, ethanol, gelatin sponge embolization in 12 cases, the treatment of 1 to 3 times. Surgical alone 57 cases (non-TACE group). AI was detected by TUNEL method and the expression of Bcl-2, Bax, p5 3, Ki-67 and PCNA was detected by immunohistochemistry. Results The expression of p5 3 protein in the cord-type and clear-cell type was significantly lower than that in the pseudo-gland type, solid type, poorly differentiated or undifferentiated type and sclerotic type (P <0.05). With the increase of pathological grade, (P <0.05). The expression of p53 protein was positively correlated with the expression of PCNA and Ki-67 protein (P <0.05), but negatively correlated with the expression of AI and Bcl-2 / P <0 0 5). The expression of p53 protein in group A was significantly higher than those in group B, C, D and surgery alone. The level of p53 protein in group B was significantly higher than that in group C and D. The level of p53 protein in group D was significantly lower than that in group C (P <0.05). Conclusions The expression of p5 3 protein in hepatocellular carcinoma after chemoembolization can enhance the proliferation and inhibit the apoptosis of cancer cells