The Relationship Between P53and Cyclind1Expression In Esophageal Carcinoma And The Clinical Features And Prognosis

Objective: To study the expression of p53and cyclind1in esophagealtissue and analyze their relationship with the clinical factors in patients withesophageal cancer and their prognosis, and to analyze the related factors in theprognosis of patients with esophageal cancer, with the aim to provide areference for their prognosis.Methods: The paraffin-embedded specimens of123cases of esophagealcancer resection surgery were selected in the Fourth Hospital of HebeiMedical University from January to November,2000. All patients had adetailed clinical and pathological data. The expression of p53and cyclind1was examined by immunohistochemical SP and the p53and cyclind1positivegastric cancer tissue was taken as a positive control. And123patient’s clinicalpathological factors and the follow-up data were collected. SPSS17.0statistical software package was used for data analysis to study the relationshipbetween p53and cyclind1and pathological factors, and to group patientsaccording to the corresponding index expression. Kaplan-Meier method wasused to make the single factor analysis on the survival rate of patients and todraw survival charts; Cox regression model analysis was made on the impactof multi-factors analysis influencing survival time; the main factors affectingthe survival rate were clear.Result:1The expression of p53and cyclind1of in123cases of esophageal carcinomatissue:The positive expression rate of p53was35.8%, with44cases of positiveexpression and79cases of negative expression. The positive expression rateof cyclind1was29.3%, with36cases of positive and87cases of negative expression.2The p53expression in123cases of esophageal cancer tissue and thecorrelation with clinical pathological factorsThe expression of p53different clinic pathological parameters inesophageal cancer tissue: invasion lesion of depth of T stage （T₃+T₄） group thep53positive expression rate was higher than that of the (T_is+T₁+T₂) group（χ²=695.7, P<0.05）; the expression of p53in esophageal carcinoma lymphnode metastasis was higher than that of the lymph node metastasis negativegroups（χ²=8.603, P<0.05）; the p53expression rate of smoking positive groupwas higher than that of the smoking negative group （χ²=3.696, P=0.041）; thep53expression of alcohol drinking positive group was higher than that of thenegative group （χ²=4.845,P=0.024）; the p53expression in esophagealcarcinoma distant metastasis positive group was higher than that in distantmetastasis-negative group （χ²=6.921, P <0.05）. p53expression had norelationship with the patient’s age, gender, the length of diseased tissue lesion,the histological type, lesion location and the degree of the lesion’sdifferentiation （P>0.05）.3The cyclind1expression in123cases of esophageal cancer tissue and thecorrelation with clinical pathological factorsThe expression of cyclind1’s different clinicopathological parameters inesophageal carcinoma: the CyclinD1expression rate of lesions invasion depthT stage （T₃+T₄） group was higher than that of the (T_is+T₁+T₂) group （χ²=5.511, P <0.05）; the cyclind1expression rate of esophageal carcinoma lymphnode metastasis positive group was higher than that of the lymph nodemetastasis negative group （χ2=7.167, P <0.05）; the cyclind1expressionrate of alcohol drinking the positive group was higher than that of the alcoholdrinking negative group （χ2=4.377, P=0.032）; the cyclind1expressionrate of esophageal carcinoma distant metastasis positive group was higher thanthat of the cyclind1expression in distant metastasis-negative group （χ2=4.177, P<0.05）. cyclind1expression had no differentiation with the patients ’age, gender and diseased tissue lesion length, histological type, lesion location, lesion degree of differentiation and whether smoking or not （P>0.05）.4The correlation analysis of p53and CyclinD1: the p53and cyclind1correlation coefficient is0.340, P <0.001. It was statistically significant,indicating a positive correlation between p53and cyclind15Survival of123cases of esophageal cancer patients with single factoranalysisFor the patients with lesions in the upper thoracic （including cervical）,middle thoracic and lower thoracic, their3-year survival rate and5-yearsurvival rates were36.8%/6.1%,55.9%/39.8%,70.2%/55.2%（χ²=12.460,P=0.002） respectively; for the patients with middle and high degree oftumor differentiation and those with low degree of tumor differentiation,their the3-year and5-year survival rates were60.4%/40.5%,54.4%/37.9%（χ²=5.064,P=0.024） respectively; for lymph node-negativegroup and positive group of patients, their3-year and5-year survival rateswere69.8%/51.5%,37.1%/12.9%（χ²=26.730, P<0.001） respectively; for thepatients with negative expression and those with positive expression of p53,their3-year and5-year survival rates were68.5%/39.9%,47%/25%（χ²=13.091, P<0.001） respectively; for the patients with negative expressionof CyclinD1and those with positive expression cyclind1, their3-year and5-year survival rates were56.9%/57.6%,46.3%/22.6%（χ²=4.701,P=0.030）respectively. Base on the statistically significant standard of P<0.05, we cansee the location of disease, tumor cell differentiation degree, lymph nodemetastasis, p53expression and cyclind1expression affect the survival ofpatients. But the patients’ gender, age, tumor size, pathological type, depth ofinvasion,smoking and alcohol drinking have no statistical significance on theprognosis of survival.6Cox multi-factor analysis of123cases of patients with esophageal cancerprognosisLymph node metastasis,alcohol drinking and P53expression have aneffect on the overall survival. The relative risk were3.375,1.897and1.979respectively. Conclusions:1The expression of p53and cyclind1in cancer tissues enhances with themetastasis of lymph node and the increases of the infiltration depth.2The expression of p53and cyclind1in carcinoma tissue correlates positively3The positive expression of p53and cyclind1has a significant impact on3years and5years survival rate of the patients. Lesion location and degree ofdifferentiation of the diseased tissue and lymph node metastasis also affect thepatients’ survival rates. But the patients’ age, gender, lesion length, lesiondepth of invasion, histological type, smoking and alcohol consumption haveno significant correlation with the survival rate of the patients.4Cox multivariate analysis of prognostic: lymph node metastasis, alcoholdrinking and P53expression affect the prognosis of patient and can be used asindicators of prognosis.