rAd-p53瘤内注射前后鼻咽癌原发灶p53、p21WAF1蛋白的表达及意义

摘要

Objective To investigate the expression of p53 protein and p21WAF1 protein when the recombinant human p53 adenovirus( rAd-p53 )before and after nasopharyngeal primary site intratumoral injection, and to investigate its significance. Methods 51 patients who were diagnosed with advanced nasopharyngeal carcinoma were randomly divided into two groups, treatment group( 27 cases )were treated with tAd-p53 intratumoral injection and concurrent chemo-radiotherapy,and control group( 24 cases )were treated with concurrent chemo-radiotherapy. Clinical data and the nasopharyngeal tumor tissues were collected after intratumoral injection with tAd-p53. And the p53 protein and p21 wan protein expression in the primary tumor tissue of nasopharyngeal carcinoma were detected by immunohistochemistry two step method. Results In treatment group, the p53 protein and p21WAF1 protein expression rates were 33.33％ and 33.3％ before tAd-p53 intratumoral injection and concurrent chemo-radiotherapy,and 62.96％ and 77.77％ after treatment.Both positive expression rate improved obviously after treatment ( P ＜0.05 ). In control group,the p53 protein and p21WAF1 protein expression rates were 40.74％ and 37.5％ respectively before chemo-radiotherapy,and 51.85％ and 50. 0％ after treatment. Both p53 protein and p21wan protein expression heightened after treatment, but there were no statistically significant difference between the two groups( P ＞ 0.05 ). Conclusion The increasing p53 protein expression leads to the increasing expression of p21WAFl protein in nasopharyngeal primary site after tAd-p53 intratumora]injection, which may be the mechanism of nasopharyngeal carcinoma treatment.%目的 探讨重组人p53腺病毒(rAd-p53)瘤内注射前后的鼻咽癌原发灶中p53蛋白、p21WAF1蛋白的表达情况及其意义.方法 51例中晚期鼻咽癌的患者随机分为两组,治疗组27例rAd-p53瘤内注射+同步放化疗,对照组24例同步放化疗.分别收集临床资料及rAd-p53瘤内注射前后鼻咽部瘤体组织标本.采用免疫组化二步法检测鼻咽癌原发灶组织标本中p53蛋白、p21WAF1蛋白的表达情况.结果 治疗组治疗前、后鼻咽癌原发灶p53蛋白和p21WAF1蛋白阳性表达率分别为33.33.0%和33.3%、62.96%和77.77%,p53蛋白和p21WAF1蛋白阳性表达率在治疗后均明显提高,治疗前后比较差异均有统计学意义(P均＜0.05).对照组治疗前、后鼻咽癌原发灶p53蛋白和p21WAF1蛋白的阳性表达率分别为40.74%和37.5%、51.58%和50.0%,两者治疗后也有所增高,但治疗前后比较差异均无统计学意义(P均＞0.05).结论 rAd-p53瘤内注射后,鼻咽癌原发灶p53蛋白表达增加进而导致p21WAF1蛋白表达增加,可能是其治疗鼻咽癌的作用机制之一.