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目的探讨血清p53抗体与Ⅲ期非小细胞肺癌临床病理特征之间的关系,并与组织中突变型p53蛋白进行对照。方法正常组30例,肺良性疾病组10例,肺癌组45例,肺癌组分别于手术前1 d,术后10、30、60和90 d时抽取清晨空腹静脉血2 ml,其中23例肺癌病例于手术后120 d,15例病例于手术后180 d抽取清晨空腹静脉血2 ml,肺良性疾病组分别于手术前1 d抽取清晨空腹静脉血2 ml,检测血清p53抗体。正常组清晨空腹采集静脉血2 ml。采用酶联免疫吸附法(ELISA)。并在良性组和肺癌组病理组织检测突变型p53蛋白。结果 p53抗体阳性率经χ2检验,在肺癌组分别与正常人组和良性病例组差异有显著性(P﹤0.05),良性病例组和正常人组之间差异无显著性(P﹥0.05)。p53抗体在鳞癌中的阳性率明显高于腺癌。p53抗体阳性滴度与肿瘤大小具有相关性。血清p53抗体手术后10 d与手术后30 d比较差异有显著性。肿瘤组织中的p53蛋白和患者血清中的p53抗体具有明显的相关性。在行根治性切除术后,肺癌患者血清p53抗体水平逐渐降低,术后30d左右可降至正常人水平;而行姑息性切除者,术后30 d血清p53抗体水平不能降至正常水平;如术后有肺癌复发和转移者,术后血清p53抗体水平可再度升高。结论血清p53抗体可间接反映p53基因突变,血清p53抗体水平有助于肺部良恶性疾病的诊断。手术前后动态测定肺癌患者血清p53抗体的变化规律,有助于判断疗效,监测预后和指导肺癌术后的综合治疗。
Objective To investigate the relationship between serum p53 antibody and clinicopathological features of stage Ⅲ non-small cell lung cancer (NSCLC) and to compare with the mutant p53 protein in tissues. Methods 30 cases of normal group, 10 cases of benign lung disease group, 45 cases of lung cancer group, lung cancer group were preoperative 1 d, 10, 30, 60 and 90 d after the fasting venous blood drawn 2 ml, of which 23 cases of lung cancer In 120 cases of postoperative day, 15 cases of fasting blood samples were collected for 2 days at 180 days after operation. Lung benign disease patients were given 2 ml of fasting venous blood samples 1 d before operation, respectively. Serum p53 antibody was detected. Normal group fasting blood samples collected 2 ml. Enzyme-linked immunosorbent assay (ELISA) was used. The mutant p53 protein was detected in the pathological tissues of benign and lung cancer groups. Results The positive rate of p53 antibody by χ2 test showed significant difference (P <0.05) between benign and malignant lung cancer group, and no significant difference between benign and normal controls (P> 0.05). The positive rate of p53 antibody in squamous cell carcinoma is significantly higher than that of adenocarcinoma. The positive rate of p53 antibody was correlated with tumor size. Serum p53 antibody 10 d after surgery and 30 d after surgery were significantly different. There is a clear correlation between the p53 protein in the tumor tissue and the p53 antibody in the patient’s serum. After radical resection, the level of serum p53 antibody gradually decreased in patients with lung cancer, and the level of p53 antibody in patients with lung cancer decreased to normal level after 30 days. However, the levels of serum p53 antibody in patients with palliative resection could not be reduced to normal levels at 30 days. Postoperative lung cancer recurrence and metastasis, postoperative serum p53 antibody levels can be increased again. Conclusions Serum p53 antibody can indirectly reflect the mutation of p53 gene. The level of serum p53 antibody is helpful for the diagnosis of benign and malignant pulmonary diseases. The dynamic change of serum p53 antibody in patients with lung cancer before and after surgery can help to judge the curative effect, monitor the prognosis and guide the comprehensive treatment of postoperative lung cancer.