目的: 探讨p53 和NF－κBp65 蛋白在胃腺癌中表达及与临床病理特征的关系。方法: 采用免疫组化
S－P 法检测100 例胃腺癌及42 例胃腺癌淋巴结转移灶中p53 和NF－kBp65 蛋白表达水平。结果: 胃腺癌组织中
p53 阳性表达率为53%。低分化胃腺癌组的阳性表达率明显高于中高分化胃腺癌组的阳性表达率( χ² = 7． 486，
P＜0． 01) ; 在有淋巴结转移的胃腺癌组中阳性的表达率明显高于无淋巴结转移的胃腺癌组( χ²= 6． 368，P＜0． 05) ;
Ⅲ、Ⅳ期胃腺癌组的阳性表达率明显高于Ⅰ、Ⅱ期组的阳性表达率( χ² = 13． 864，P＜0． 01) ; 胃
底/贲门、胃体、胃窦/幽门胃腺癌之间的阳性表达率无显著差异性( χ² = 2． 529，P＞0． 05) 。胃腺癌组织中NF－
κBp65 阳性表达率为58%。低分化、中高分化胃腺癌之间，有淋巴结转移、无淋巴结转移胃腺癌之间，Ⅲ、Ⅳ期和
Ⅰ、Ⅱ期胃腺癌之间的阳性表达率均存在显著的差异性( χ² = 4． 624，P＜0． 05; χ² = 3． 876，P＜0． 05; χ² = 7． 436，P
＜0． 01) ，而胃腺癌部位阳性表达率无显著差异性( χ² = 3． 306，P＞0． 05) 。42 例淋巴结转移灶中p53 和NF－kBp65
阳性表达率分别为30． 95%和35． 71%，均明显低于胃腺癌原发灶( χ² = 4． 861，P＜0． 05; χ² = 8． 052，P＜0． 05) ，p53
和NF－kBp65 在胃腺癌原发灶和淋巴结转移灶中的表达均呈正相关( c = 0． 505，P = 0． 001; c = 0． 316，P = 0． 041) 。
结论: p53 的异常表达和NF－κBp65 分别在胃腺癌的发展、侵袭和转移中起到重要作用; p53 的和NF－κBp65 在胃
腺癌中协同表达，提示可能共同参与胃腺癌的增殖、侵袭和转移; 联合检测胃腺癌中p53 和NF－κBp65 表达，可
为临床诊断病情发展程度提供指导意义。

Objective: To explore the protein expression levels of p53 and NF－kBp65 in the tissues
of Gastric adenocarcinoma，and their relationship with patients’clinical and pathological features．
Methods: Immunohistological S－P staining was used to detect p53 and NF－kBp65 protein expression
in 100 cases of primary tumor tissues，and in 42 cases of lymph node metastasitic tissues． Result: The
percentage of p53 positive is 53% in this group of gastric adenocarcinoma patients． The p53 positive
rate is significantly higher in poorly differentiated group than in both moderately and well differentiated
groups( χ² = 7． 486，P＜0． 01) ， significantly higher in these with lymph node metastasis than in these
without metastasis( χ² = 6． 368，P＜0． 05) ，and significantly higher in these at stage III or VI than in
these at stage I or II( χ²= 13． 864，P＜0． 01) ． There is no significant difference comparing the positive
rates among sub－groups of fundus /cardiac，corpus，antral /pyloric adenocarcinomas． The percentage of
NF－kBp65 positive is 58% in the whole group，and there is significant difference between poorly and
moderately /well differentiated adenocarcinomas，between these with lymph node metastasis and without
metastasis，and between these at stage III or IV and these at stage I or II． The positive rates of p53 and
NF－kB are 30． 95%and 35． 71 respectively in 42 cases of patients with lymph node metastasis． These
positive rates are significantly lower than in non－metastasis cases( χ²= 4． 861，P＜0． 05; χ²= 8． 052，P
＜0． 05) ． There is a positive correlation between expression of p53 and NF－kBp65 in primary tumor and
metastastic lymph node tissues． Conclusion: The abnormal expression of p53 plays a critical role in
the development，invision and metastasis of gastric adenocarcinoma． The co－expression of p53 and
NF－kB in tumor tissues implies that the interaction of these proteins may be involved in the proliferation，
invision and metastasis of gastric adenocarcinoma． Detection of p53 and NF－kBp65 as a
pair of biomarkers may provide indicative information for the prediction of tumor development and
patient’s prognosis．

R573

 收稿日期: 2013－08－03; 修回日期: 2013－11－04
基金项目: 内蒙古自治区自然科学基金资助项目( 2012MS1111)
作者简介: 杨晓艳( 1983－) ，女，呼和浩特市第一医院消化科住院医师。
通讯作者: 陈春华，教授，硕士研究生导师． E－mail: chunhuachen@126． com 内蒙古医科大学附属医院消化科， 010050