肝门部胆管癌患者癌组织中淋巴增强因子1的表达及P53蛋白突变的临床意义

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目的:分析淋巴增强因子1(lymphoid enhancer factor-1,LEF-1)与P53蛋白在肝门部胆管癌组织中的表达及临床意义。方法:回顾性分析2010年3月至2017年12月唐山市人民医院就诊的50例肝门部胆管癌患者的临床资料,采用免疫组织化学方法检测P53蛋白突变情况,同时检测LEF1蛋白在胆管癌癌组织及癌旁正常组织中的表达,分析LEF1的表达情况及与临床病理参数的相关性,同时探讨P53蛋白突变情况与LEF1蛋白表达的相关性及与患者预后的关系。结果:LEF1蛋白在癌组织的阳性表达率为62.00%(31/50),高于癌旁正常组织的阳性表达率36.00%(18/50),两者比较差异有统计学意义(χn 2=6.763,n P=0.016);P53蛋白突变型的胆管癌患者28例,野生型22例,在P53蛋白突变型的患者中LEF1阳性率为75.00%(21/28),明显高于P53野生型组(45.45%,10/22),两组比较差异有统计学意义(χn 2=4.565,n P=0.03)。LEF1表达与肿瘤的分化程度、TNM分期、淋巴结转移以及P53蛋白突变有关(n P均<0.05),LEF-1的表达与P53蛋白突变表达呈正相关(n r=0.295,n P=0.042)。P53蛋白突变型患者1年累计生存率明显低于P53蛋白野生型患者(60%与81%,n P=0.042),LEF1阳性表达患者的1年累计生存率亦明显低于阴性表达患者(53%与82%,n P=0.018)。n 结论:LEF-1在肝门部胆管癌组织中高表达,且高表达患者的预后较差。P53蛋白突变的肝门部胆管癌患者LEF-1阳性表达增高,且P53蛋白突变患者预后差。“,”Objective:To analyze the expression and clinical significance of lymphoid enhancer factor-1 (LEF-1) and P53 protein in hilar cholangiocarcinoma.Methods:A total of 50 cases with hilarcholangiocarcinoma in the Tangshan People′s Hospital from March 2010 to December 2017 were retrospectively analyzed.P53 protein mutation was detected by immunohistochemistry.At the same time, the expression of LEF1 protein in cholangiocarcinoma and adjacent normal tissues was detected.The expression of LEF1 and its correlation with clinicopathological parameters were analyzed.At the same time, the relationship between p53 protein mutation and LEF1 protein expression and the prognosis of patients were discussed.Results:The positive expression rate of LEF1 in tumor tissues were 62.00%(31/50), which was higher than in adjacent tissues 36.00% (18/50). The difference was statistically significant (χn 2=6.763, n P=0.016). There were 28 patients with TP53 protein mutation and 22 patients with wild type.The positive rate of LEF1 in TP53 mutant group was 75.00% (21/28), which was significantly higher than that in TP53 wild type group(45.45%, 10/22), and the difference was statistically significant(χn 2=4.565, n P=0.03). The LEF1 expression was associated with tumor differentiation, TNM stage, lymph node metastasis and TP53 protein mutation (all n P<0.05). LEF-1 expression was positively correlated with TP53 protein mutation (n r=0.294, n P=0.04). The 1-year cumulative survival rate of patients with TP53 protein mutation was significantly lower than that of patients with TP53 protein wild type (60% vs.81%, n P=0.0416). The 1-year cumulative survival rate of patients with LEF1 positive expression was also significantly lower than that of patients with negative expression (53% vs.82%, n P=0.0180).n Conclusion:LEF-1 is highly expressed in hilar cholangiocarcinoma, and patients with high expression have poor prognosis.The positive expression of LEF-1 in hilar cholangiocarcinoma patients with TP53 protein mutation was increased, and the prognosis of patients with TP53 protein mutation was poor.
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