摘要
52例星形细胞瘤应用免疫组化方法,检测癌基因p^(53)、C-erbB-2及增殖细胞核抗原(PCNA)的表达,结果发现①p53异常表达率为41.2%(24/52),C-erbB-2过度表达率为39%(20/52),PCNA(PI>0.05)增殖指数为77%(40/52),与对照组正常脑组织对比有显著差异(P<0.001).②p53,C-erbB-2,PCNA异常表达与病理级别有明显相关性.病理Ⅲ,Ⅳ级的阳性率分别为80%(16/20),40%(8/20),100%(20/20),(P<O.001);Ⅱ级的阳性率为33.3%(8/24),50%(12/24),83.3%(20/24),(P<0.01):Ⅰ级的阳性率为0.③p53阳性组,PCNA指数(PI):0.552±0.322,阴性组PCNA指数为0.24±0.308,两组间无差异(P>0.05);C-erbB-2阳性组,PCNA指数;0.361±0.27,阴性组PCNA指数;0.399±0.39,两组间亦无差异(P>0.05).④11例胶质增生组织有1例(9%)显示p53表达,C-erbB-2,PCNA无表达.随访3年,病变复发,病理证实为星形细胞瘤Ⅰ～Ⅱ级,C-erbB-2,PCNA表达.结果提示:①星形细胞瘤p53、C-erbB-2及PCNA的异常表达可作为星形细胞瘤恶性程度及病人预后的指标,以p53过度表达尤为重要;②3种抗体的联合应用对星形细胞瘤发病机理研究及预测早癌发生有一定价值,p53异常表达主要是影响星形细胞瘤的分化,而C-erbB-2对肿瘤进展早期起一定作用.③胶质增生的胶质细胞具有恶性表型.
Aberrant expression of the p53, C-erbB-2 proto-oncogene and proliferating cell nuclear antigen (PCNA) were evaluated in 52 cases of astrocytic neoplasms, 11 with gliosis and 10 normal brain for comparison by means of im-munohistochemical SP method . The results showed that (1) strong nucleus staining was found in 41, 2%(24/52) of tumors for p53 protein, 39% (20/52) of tumors for membrane bound C-erbB-2 oncoprotein and 77%(40/52) of tumors for (PI>0. 05) PCNA proliferating cell index, More astrocytomas were stained comparing with normal brain control (P<0. 001). (2) aberrant expression of p53,C-erbB-2 and PCNA shpwed a strong correlation with malignancy grade. The stains were positive in 80%, 40%, 100% of malignant neoplasms (grades Ⅲ and Ⅳ) and in 33. 3%,50%,83. 3% of grade Ⅱ astrocytomas (P<0. 01), whereas none of the grade I tumors was positive, (3) p53,CerbB-2 expressions were not significantly associated with proliferation rate determined by immuno-histochemical PCNA stainig (median PCNA- Labeling index; 0. 552 ± 0. 322 (p53-positive) versus 0, 240±0. 308(p53-negative),P>0. 05; 0. 361±0, 270 (C-erbB-2-positive) versus 0. 399?0, 390 (C-erbB-2-negative) P > 0. 05. (4) the gliosis cell showed p53 protein immunoreac-tivity,but without C-erbB-2 and PCNA expression, which had been followed up for 3 years. Diagnosis had been made as grade I-Ⅱ astrocy-tomas by pathology , and aberrant expression of C-erbB-2 and PCNA.The results suggest that:(1) p53, CerbB-2 and PCNA expression may be served as the indicators for identifying the extent of the disease in astrocytomas patients. The p53expression is more frequent than abnormal C-erbB-2 expression. (2) The application of p53, C-erbB-2 and PCNA protein co-expression seem to be superior methods for investigating the pathogenesis of astrocytomas and detecting early astrocytomas. Aberrant expression of the p53 effect differentiation of astrocytomas, and C-erbB-2 plays an important role in detecting astrocytomas growth. (3) The cell of gliosis might be associated with the premalignant phenotype.
