The Expression Of P16Protein And P38Protein And Its Clinical Significance In Esophageal Carcinoma

Objective: To study the expression of p16protein and p38protein and itsclinical significance in esophageal carcinoma, analysis of its correlation withclinicopathological factors and prognosis in esophageal cancer patients,explore the correlation of its expressed in esophageal cancer tissues and itsrole in predicting the prognosis of patients with esophageal cancer.Methods: Choose the fourth hospital of Hebei Medical University duringthe period from2000January to2000November, the Department of thoracicsurgery operation excision in the treatment of123cases of esophageal cancerparaffin as experimental samples, the expression of p16protein and p38protein were detected by immunohistochemical SP method in group of123patients with esophageal carcinoma. Collating the selected patient clinicalinformation and follow-up data, using statistical methods, according to theexpression level of each index, grouped according to predetermined criteria,analysis of the relationship between p16protein and p38protein and clinicalpathological factors, the application of Kaplan-Meier method (1og-rank test),effect of single factor analysis and COX regression model for survival the(multivariate analysis), to analyze the survival of esophageal carcinomapatients, to explore the main factors affecting the survival rate.Result:1Determination of P16protein and P38protein1.1123cases of esophageal carcinoma, the expression of P16was positive in59cases, negative in64cases, the positive rate was47.97%.1.2123cases of esophageal carcinoma, the expression of p38was positive in64cases, negative in59cases, the positive rate was52.03%.2The correlation between the expression of p16in esophageal carcinoma andits clinical pathological factors. Under different clinical cases, esophageal tissue expression of p16display: carcinoma with invasion depth: T staging (Tis+T1, T2) and p16positive expression of group was obviously higher than that of (T3and T4)group (chi-square=28.829, P <0.001); Cancerous tissue differentiationdegree: medium-high p16positive expression of differentiation group wasobviously higher than in low differentiation group (chi-square=9.050, P=9.050); Lymph node metastasis: no lymph node metastasis of esophagealcancer tissue, p16positive expression was significantly higher with lymphnode metastasis (chi-square=11.433, P=11.433); Lesion length:<p16positive expression of3cm group was obviously higher than that of P3cmgroup (chi-square=6.739, P=6.739); Lesion location: chest piece+neck,chest and chest piece of positive expression of p16have significant differencesbetween group (chi-square=14.106, P=14.106); With patient’s sex, age,pathological type, presence of distant metastasis has nothing to do.3The correlation between the expression of p38in esophageal carcinoma andits clinical pathological factors.Under different clinical cases, esophageal tissue expression of p38lightning show: carcinoma with invasion depth: T staging (T3and T4) groupof p38lightning positive expression was significantly higher (Tis+T1, T2)group (chi-square=5.74, P=0.016; carcinoma tissue differentiation degree,p38lightning positive expression of poorly differentiated group was obviouslyhigher than that of medium-high differentiated group (chi-square=6.945, P=6.945) and lymph node metastasis: with lymph node metastasis ofesophageal cancer tissue, p38lightning positive expression were significantlyhigher than those without lymph node metastasis is (chi-square=5.118, P=0.024); the lesion length:3cm or higher p38lightning positive expression ofgroup was obviously higher than that of <3cm group (chi-square=16.827, P<0.001); the lesion location: chest piece+neck, chest and chest piece ofpositive expression of p38lightning have significant differences betweengroup (chi-square=13.835, P=0.001; and with the patient’s gender, age,pathological type, presence of distant metastasis has nothing to do. 4Correlation between the expression of p16and p38in esophageal carcinomaThe degree of differentiation of esophageal cancer is higher, infiltrationdepth is more shallow, without lymph node metastasis, the positive rate of p16is higher, and the positive rate of p38expression is lower; and the low degreeof differentiation, invasion depth, lymph node metastasis, the positive rate ofp38is high, the expression rate of p16was low, and the with the patient’s sex,age, pathological type, there is no distant metastasis. Between the two inesophageal cancer expression correlation significantly (r=-0.251, P=0.005),negative correlation.5Survival analysis of patients with esophageal cancerThe selected of123patients with esophageal cancer, By the end offollow-up,88cases of death,35cases were lost to follow-up(died in cases ofesophageal cancer in death group; death from other causes of pathologicalgroup as lost to follow-up). Application of Kaplan Meier method (log-ranktest) and COX regression model analysis of gender, age, tumor location, tumorsize, infiltration depth and histological type, differentiation degree and lymphnode metastasis, distant metastasis, and expression of p16protein and p38protein on the survival of patients with esophageal cancer.5.1Single factor analysis of influence the prognosis of patients withesophageal cancerThis experiment concluded that the following data: the lesion location:the upper thoracic+cervical,middle thoracic and lower thoracic survival periodin3years and5years survival rates is36.8%6.1%,55.9%and70.2%/55.2%/39.8%/(P=0.002); Lesions with differentiation: the middle-highdifferentiated and poorly differentiated groups in the3years survival rate andthe5-year survival rate is:60.4%,40.5%/60.4%/37.9%(P=0.024); Lymphnode metastasis: without lymph node metastasis and lymph node metastasis inpatients in the3years survival rate and5-year survival rate is respectively69.8%,51.5%/69.8%/69.8%(P <0.001); The expression of p16:p16negative expression and p16positive expression in3years of survival rate,5years of survival rate is respectively57.6%,26.5%/57.6%/57.6%(P= 0.039); The expression of p38: p38expression negative and p38expressionpositive in3years of survival rate,5years of survival rate is respectively64.4%,47.7%/64.4%/64.4%(P=0.035). Above factors by log-rank test,the p values were less than0.05, according to standard P=0.05, statisticallydifference, therefore, the tumor lesion location, degree of differentiation, thepresence of lymphatic and transfer, p16and p38expression in3year survivalrate and5-year survival rate have significant difference. Lesion location nearerthe lower esophageal segment, the higher survival rate, without lymphaticmetastasis cases than the cases with lymph node metastasis survival rate ishigher, the survival rate of middle-high differentiated cases is higher thanpoorly differentiated cases,p16expression positive cases than the negativecase for high survival rate, P38express negative cases than the positive forhigh survival rate. However, the esophageal cancer patients gender, age,degree of tumor differentiation, pathological type, tumor size, invasion depth,the impact on the prognosis of survival has no statistical significance.5.2Analysis of prognosis of patients with esophageal cancer Cox multivariatemodelThe tissue differentiation, pathological type and lymph node metastasis(B) respectively corresponding to0.519/0.970/1.150; standard error (SE) is0.248/0.433/0.262; Wald statistics for4.380/5.022/19.242; P=0.036/0.025/0.000, the value of P is <0.05, with statistical significance, thataffect the survival time of these three factors on the patients with esophagealcarcinoma. Therefore, affect the risk of overall survival factors are: the degreeof differentiation,pathological tissues of esophageal cancer type and lymphnode metastasis. But with age, gender, tumor location, tumor size, depth ofinvasion free no obvious correlation.Conclusion:1With the development of esophageal cancer patients with lymph nodemetastasis, differentiation degree reduction and the invasion depthdeepened,the positive expression of p16in cancer tissues was significantlylower, the positive expression of p38was significantly higher, the positive expression of p16and p38in esophageal carcinoma was negativelycorrelation.2Univariate analysis of prognosticThe positive expression of p16, the negative expression of p38havesignificant influence on esophageal cancer patients3years survival rate and5year survival rate.At the same time proves that the location of the tumor,thedegree of differentiation and lymph node metastasis, have a significant impacton the prognosis of the patients.But age, gender, pathological type, tumor size,depth of invasion,no effect with prognosis of patients.3Cox multivariate analysis of prognosticThe degree of differentiation, pathological type and lymph nodemetastasis are risk factors have influence on the survival of patients withesophageal cancer.Lymph node metastasis (Exp (B)3.157) is the highestrisk factors of the prognosis of patients with esophageal cancer.