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目的 研究大肠癌患者血清 p53 Ab与 p53基因突变及蛋白表达之间关系 ,以探讨p53基因在大肠癌发生与早期诊断中的作用及其临床意义。方法 运用ELISA法检测 34例大肠癌及 10例健康对照组血清 p53 Ab ,同时运用PCR SSCP与IHC法分析p53基因第 5～ 8外显子突变及蛋白表达情况。结果 34例大肠癌中 ,p53 Ab阳性率为 17 6 % (6 /34) ,正常对照组均为阴性。大肠癌组织中p53基因第 5～ 8外显子突变及蛋白表达阳性率分别为52 9% (18/ 34)和 55 9% (19/ 34) ,正常粘膜未见p53蛋白表达。 12例癌组织中有 p53基因突变的患者其粪便中基因突变阳性率为 4 1 6 % (5/ 12 )。p53蛋白表达与基因突变呈正相关 (rs=0 349,P <0 0 5) ,p53 Ab存在与 p53基因突变及蛋白表达均无关 (P >0 0 5)。p53基因突变、蛋白表达及 p53 Ab存在与腺癌组织分化、淋巴结转移及其它临床病理因素均无关 (P >0 0 5)。结论 p53基因突变是参与和影响 p53蛋白表达和生物学功能的主要因素。p53基因突变或蛋白表达可诱导 p53 Ab产生 ,但不是其产生的唯一决定因素。ELISA法检测血清p53 Ab对于诊断大肠癌具有 10 0 %特异性 ,血清p53 Ab的检测可成为一种新的肿瘤标记物用于大肠癌的诊断及高危人群的筛检普查。
Objective To study the relationship between serum p53 Ab and p53 gene mutation and protein expression in patients with colorectal cancer to explore the role and clinical significance of p53 gene in the occurrence and early diagnosis of colorectal cancer. Methods The serum p53 Ab in 34 cases of colorectal cancer and 10 healthy controls were detected by ELISA. The mutations and protein expression of exons 5-8 of p53 gene were analyzed by PCR SSCP and IHC. Results In 34 cases of colorectal cancer, the positive rate of p53 Ab was 17 6% (6/34). The normal control group was negative. The positive rates of mutations and protein expression of exon 5-8 of p53 gene in colorectal cancer tissues were 52 9% (18/34) and 55 9% (19/34) respectively. No p53 protein expression was observed in normal mucosa. Among the 12 patients with p53 mutation in cancer tissues, the positive rate of mutations in feces was 41.6 % (5/12). There was a positive correlation between p53 protein expression and gene mutation (rs=0 349, P<0 05). The presence of p53 Ab was not associated with p53 gene mutation and protein expression (P > 0.05). The p53 gene mutation, protein expression and the presence of p53 Ab were not associated with histological differentiation, lymph node metastasis, and other clinicopathological factors (P > 0.05). Conclusion p53 gene mutations are the major factors involved in and affect the expression and biological function of p53 protein. Mutations or protein expression of p53 can induce the production of p53 Ab, but it is not the only determinant of its production. ELISA detection of serum p53 Ab is 100% specific for the diagnosis of colorectal cancer. The detection of serum p53 Ab can be used as a new tumor marker for the diagnosis of colorectal cancer and screening screening of high-risk groups.