RELATIONSHIP BETWEEN p53 OVEREXPRESSION AND p21/wafl EXPRESSION AND THE EFFECT OF HAI CHEMOTHERAPY AGAINST COLORECTAL LIVER METASTASIS

本研究旨在探讨p53过表达与p21/WAFL表达的关系及HAI化疗对结直肠癌肝转移的影响。P53在结直肠癌原发灶和肝转移灶中的阳性表达率分别为48.0%和46.7%。原发灶p21/WAFL染色阳性率为38.7%，肝转移灶阳性率为30.7%。结论：1.转移灶与原发灶的染色状态相似，许多病例中p53和p21/wafl2的表达情况相似。P53的表达与021/wafl3呈显著负相关。累积无复发率在p53阳性组为67.0%，在p53阴性组为81.7%(p&gt；0.05)，在p21/WAFL阳性组和阴性组分别为40.1%和82.6%(p&gt；0.05)。P53阳性、p21/WAFL阴性肿瘤累计复发率为48.8%，P53阴性、P21/WAFL阳性肿瘤累计复发率为80.0%(P&lt；0.05)。P53阳性和p21/WAFL阴性的结直肠癌5年生存率分别为31.8%和70.1%(P&lt；0.05)。结论：结直肠癌中P53的过度表达和p21/WAFL的联合表达可作为预测HAIC提示肝转移辅助化疗的指标。

In this study, we search the relationship between p53 overexpression and p21/wafl expression and the effect of HAI chemotherapy against colorectal liver metastasis.Seventy-five patients undergoing curative resection of liver metastasis of colorectal cancer at Yokohama City University Hospital between 1992 to 1996 were enrolled in this study.We revealed that1. Result of p53 staining rate were 48.0% in primary lesion and 46.7% liver metastasis of colorectal cancer. Result of p21/wafl staining rate were 38.7% in primary lesion and 30.7% liver metastasis. Staining status was similar in metastatic lesion compared to primary lesions in many cases both p53 and p21/wafl.2. There was a significant inverse relationship between the expression of p53 and 021/wafl.3. Cumulative recurrence-free ratio was 67.0% in p53 positive tumor and 81.7% in p53 negative tumor (p>0.05), and 40.1% in p21/wafl positive tumor and 82.6% in p21/wafl negative tumor (p>0.05).4. Cumulative recurrence ratio was 48.8% in p53 positive and p21/wafl negative tumor and 80.0% in p53 negative and p21/wafl positive tumor (p<0.05). 5-year survival ratio was 31.8% in p53 positive and p21/wafl negative tumor and 70.1% in p53 negative and p21/wfl positive tumor (p<0.05).In conclusion, immunohistochemical study of p53 overexpression combined with p21/wafl expression in colorectal cancer become a predictive factor of HAIC indication of adjuvant chemotherapy of liver metastasis.