膀胱癌尿脱落细胞P16、cyclin D_1、P53、mdm2蛋白表达及其意义

Expression of P16, cyclin D_1 , P53 and mdm2 proteins in exfoliated urothelial cells of transitional cell carcinoma of urinary bladder and implication

目的 :检测P16、cyclinD1、P5 3、mdm2蛋白在膀胱移行细胞癌 (TCC)尿脱落细胞中的表达 ,以探讨其临床意义。方法 :用免疫组织化学S -P法检测 2 1例膀胱TCC尿脱落细胞及组织中P16、cyclinD1、P5 3、mdm2蛋白的表达。结果 :膀胱TCC尿脱落细胞中 ,P16蛋白阳性表达率为 71.4 % (15 / 2 1) ;cyclinD1蛋白阳性表达率为 2 8.6 % (6 / 2 1) ;P5 3蛋白阳性表达率为 33.3% (7/ 2 1) ;mdm2蛋白阳性表达率为 2 3.8% (5 / 2 1)。对照组P16蛋白表达均为阳性 ,cyclinD1、P5 3、mdm2蛋白表达均为阴性。P16、cyclinD1、P5 3、mdm2基因在尿脱落细胞中异常表达均与相应的组织中表达相吻合。多基因蛋白联合表达肿瘤检出率为 81% (17/ 2 1) ,常规尿细胞学检查肿瘤检出率为19.1% (4/ 2 1)。两种方法比较差异有显著性意义 (χ2 =18.0 8,P <0 .0 0 5 )。结论 :尿脱落细胞的P16、cyclinD1、P5 3、mdm2多基因蛋白联合检测可作为膀胱TCC诊断有意义的参考指标。

objective To detect P16,cyclin D 1 , P53 and mdm2 proteins in exfoliated urothelial cells of the transitional cell carcinoma(TCC) of urinary bladder and to evaluate their clinical significance. Methods Immunohistochemical method was used to detect the P16,cyclin D 1 , P53 and mdm2 protein expression in 21 cases of exfoliated urothelial cells of the TCC of urinary bladder. Results The positive rate of P16 protein expression in exfoliated urothelial cells of the TCC of urinary bladder was 71.4%(15/21). The positive rate of cyclin D 1 protein was 28.6%(6/21). The positive rate of P53 protein was 33.3%(7/21). The positive rate of mdm2 protein was 23.8% (5/21). The abnormal expression of P16, cyclin D 1, P53,mdm2 in exfoliated urothelial cells were the same as the corresponding tissue. In noneoplastic controls, expression of P16 is positive, expression of P53,mdm2,and cyclin D 1 is negative, positive united detection rate of P16, cyclin D 1 ,P53, and mdm2 protein is 81%(17/21) and it is significantly higher than positive detection rate of routine exfoliated urothelial cells of 19.1%(4/21) (χ 2=18.08, P <0.005). Conclusion P16,Cyclin D 1 ,P53 and mdm2 protein expression in exfoliated cells have clinical significance marker for diagnosis of the TCC of urinary bladder.