肝细胞肝癌组织中P21^(WAF1/CIP1)与PCNA的表达及意义

Expressions of cyclin-dependent kinase inhibitor P21^(WAF1/CIP1) an d PCNA in human hepatocellular carcinoma

目的:检测p21WAF1/CIP1与PCNA在肝脏各种病变组织中的表达与分布情况,探讨P21WAF1/CIP1与PCNA在肝细胞癌发病机制中的作用,以及在肝良性与恶性病变鉴别诊断中的价值.方法:采用免疫组织化学方法(DakoEnVisionTMSystems)结合组织病理学观察,检测了36例慢性肝炎?28例不典型增生?52例肝细胞癌组织中的P21WAF1/CIP1与PCNA的表达与分布情况.结果:在慢性肝炎?不典型增生和肝细胞癌组织中,P21WAF1/CIP1阳性检出率明显下降,阳性检出率分别为72.2%(26/36),53.6%(15/28)和26.9%(14/52);三种病变组织中PCNA标记指数明显增加,分别为24.2±6.5%,55.6±7.2%和76.9±10.4%.P21WAF1/CIP1与PCNA的表达在三者之间均存在着显著的差别(P<0.05),明P21WAF1/CIP1与PCNA的表达均与组织分化程度相关,即组织分化程度高,P21WAF1/CIP1表达多;组织分化程度低,P21WAF1/CIP1表达少或不表达;PCNA的表达则相反.结论:在肝细胞癌发病过程中,P21WAF1/CIP1与PCNA的表达均有可能起着重要的作用;同时检测P21WAF1/CIP1与PCNA的表达?分布情况,在肝癌患者预后判断中具有辅助诊断价值.

AIM:To detect the expressions of P21WAF1/CIP1 and PCNA in liver diseases and to investigate the significance of expressions of P21W AF1/CIP1 and PCNA in hepatocellulaer carcinoma genesis and to observe the role s of P21WAF1/CIP1 and PCNA in differentiated diagnosis between the benign and malign diseases of liver. METHODS:Dako EnvisionTM Systems immunohistochemic method i n c ombination with histological pathology were used to observe the P21WAF1/CIP1 and PCNA expressions in 3 groups diseases: 36 cases of chronic hepatitis, 28 cases of atypical hyperplasia and 52 cases of hepatocellular carcinoma. RESULTS:The general positive expression rates of P21WAF1/CIP 1 in chronic hepatitis, atypical hyperplasia and hepatocellular carcinoma were 72.2%(26/36), 53.6%(15/28) and 26.9%(14/52). In the other hand, the PCNA LI (la bel index) among three-type diseases were 24.2±6.5%, 55.6±7.2% and 76.9±10.4%. The expressions of P21WAF1/CIP1 and PCNA were correlated with histologi cal differentiation. That means the positive expression of P21WAF1/CIP1 wa s higher in differentiated tissue than in non-differentiated tissue and the PCN A LI was lower in differentiated tissue than in non- differentiated tissue. The expressions of P21WAF1/CIP1 and PCNA were significantly different among three groups (P<0.05). CONCLUSION:Expressions of P21WAF1/CIP1 and PCNA may be related to the development of hepatocellular carcinoma and might have a certain va lue for the differential diagnosis and prognosis of human hepatocellular carcino ma.