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目的探讨肿瘤抑制基因ｐ５３在同一患者多灶性食管癌前病变和癌组织中的突变特征，以加深对其在食管癌发生过程中作用的认识．方法采用免疫组织化学、选择性免疫组化、ＤＮＡ（ＰＣＲＳＳＣＰＤＮＡ）测序方法，对来自食管癌高发区林州市的４３例食管癌手术切除标本的癌组织及癌旁非癌病变作Ｐ５３蛋白表达及突变分析．癌前病变和ｐ５３表达较弱的癌组织（阳性细胞＜３０％），采用紫外线照射办法提高阳性细胞数再作ＤＮＡ制备．结果受检的４３例鳞癌中，３０例检出有ｐ５３基因突变（７０％），其中２９例Ｐ５３蛋白表达阳性鳞癌中的２５例检出有ｐ５３基因突变（８６％）．对癌旁Ｐ５３蛋白表达阳性的癌前病变分析显示，１６例基底细胞增生中的７例（４７％），１２例间变中的８例（６７％），７例原位癌中的６例（８６％）检出有ｐ５３基因突变．尽管有２例受检组织突变只见于癌组织，而其癌旁的间变组织未发现突变，但间变和原位癌中检出的ｐ５３基因突变与鳞癌中检出的ｐ５３基因突变类型相同．７例基底细胞增生组织中，只有３例检出的ｐ５３基因突变类型与其邻近的癌组织相同，其余４例突变类型不同于邻近的癌组织．结论发生间变和原位癌组织的ｐ５３基因突变与食管鳞癌非常一致，而发生在基?
Objective To investigate the mutation characteristics of tumor suppressor gene p53 in multifocal esophageal precancerous lesions and cancer tissues of the same patient to deepen its understanding of the role of p53 in the development of esophageal cancer. METHODS: Immunohistochemistry, selective immunohistochemistry, and DNA sequencing were performed on 43 specimens of esophageal cancer surgically resected from Linzhou City, a high-risk area of esophageal cancer. P53 protein expression and mutation analysis. Precancerous lesions and cancerous tissues with weak p53 expression (positive cells < 30%), using ultraviolet irradiation to increase the number of positive cells for DNA preparation. Results Of the 43 squamous cell carcinomas examined, 30 had p53 mutations (70%), of which 29 had p53 mutations (86%) in 25 of 25 positive squamous cell carcinomas. Analysis of precancerous lesions with positive P53 protein expression in the paratumor showed that 7 out of 16 cases (47%) of basal cell hyperplasia, 8 cases (67%) out of 12 cases, and 6 out of 7 cases of in situ carcinoma (86%) detected mutations in the p53 gene. Although 2 cases of mutations in the examined tissues were found only in the cancerous tissue, and no mutations were found in the paracancerous tissue adjacent to them, the p53 gene mutations detected in the metastasis and carcinoma in situ and the p53 gene mutation type detected in the squamous cell carcinomas. the same. Of the 7 cases of basal cell hyperplasia, only 3 cases had the same type of p53 mutation detected as their neighboring cancer tissues, and the remaining 4 cases were different from the adjacent cancer tissues. Conclusions The p53 gene mutations that occur in interstitial and in situ cancer tissues are very consistent with esophageal squamous cell carcinoma.