目的：探讨食管鳞癌组织中p53表达水平与放化疗治疗疗效的关系。方法：选取甘肃省肿瘤医院2009年10月-2012年12月完成同步放化疗的62例局部晚期不可手术切除或患者不愿手术的食管鳞癌癌初治患者，应用免疫组织化学法检测患者病理组织中p53蛋白的表达，并分析p53蛋白表达与放化疗疗效的关系。结果：本组患者p53阳性表达率为56.5％（35/62）。p53表达与患者的性别、年龄、临床分期、ECOG ZPS评分等比较差异都无显著性（P＞0.05），而与肿瘤分化程度相关（P＜0.05）。全组患者CR24例，PR26例，SD11例，PD1例，计算出ORR为80.6％（50/62），DCR为98.4％（61/62）；p53阳性者ORR为74.3％（27/35），p53阴性者ORR为92.6％（26/27），两组ORR比较，差异有统计学意义（X2＝6.459，P＝0.011）。本组患者中位生存期为28个月，其中p53阳性组为27个月，p53阴性组为36个月。62例患者1、2、3年生存率分别为：85.5％（53/62）、64.5％（40/62）、37.1％（23/62）；其中p53阳性组1、2、3年生存率分别为94.3％（33/35）、57.1％（20/35）、34.3％（12/35），p53阴性组分别为96.3％（26/27）、81.5％（22/27）、51.9％（14/27）。Kaplan-Meier生存分析显示两组患者OS间差异有统计学意义（χ2＝4.39，P＝0.036）。结论：食管鳞癌组织中p53阴性患者放化疗的敏感性较高且预后好。%Objective:To study the expression of P53 in esophageal squamous cell carcinoma, and to investigate its relationship with curative effect of chemoradiation. Methods:Dected the expression of P53 in 62 cases of esophagus cancer for the first time treatment through the application of immunohistochemistry in Gansu province tumor hospital since October 2009 to December 2012 ,which cses had not resected by operation or patients were not want to by surgery. Analyzed the relationship between its expression with the curative effect of chemoradiation . Results:P53 showed positive expression,and it was 56.5%(35/62).p53 was positive correlation with the degree of differentitaton (P<0.05), though it were not significant differents with gender, age, clinical staging, ECOG ZPS (P>0.05).On the study CR was 24, PR was 26, SD was 11,PD was 1,ORR was 80.6%(50/62),DCR was 98.4%(61/62);ORR of positive P53 was 74.3%(27/35)and 92.6%(26/27) for negative P53 , though their comparation signed significant difference(χ2=6.459,P=0.011) .The median survival was28 months for all the patients;Positive P53 was 27 months,the other was 36months.The survival rate of 1,2,3year was respectively:85.5%(53/62)、64.5%(40/62)、37.1%(23/62);positive P53 of 1,2,3year was respectively : 77.1%(27/35)、51.4% (18/35)、25.7%(9/35);the other was respectively: 96.3%(26/27)、81.5%(22/27)、51.9%(14/27). OS of two groups showed significant difference (χ2=4.39,P=0.036) in two types by Kaplan-Meier survival analysis. Conclusions:The sensitivity of negative p53 in esophageal squamous cell carcinoma was higher and the prognosis was better than the positive P53 .
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