胰头癌P53基因、PCNA和S-100^+树突状细胞浸润关系的免疫组化研究

Immunohistochemical study on expression of p53、PCNA and relation to infiltration rate of S-100^+ DC in carcinoma of head of pancreas

目的对胰头癌恶性病变及快速增长的分子生物学标志进行研究,以判断胰头癌的预后。方法应用免疫组化染色法,对53例不同分化程度胰头癌的 P53蛋白、增殖细胞核抗原(PCNA)、S-100蛋白阳性树突状细胞(S-100^+DC)浸润情况进行了研究。结果 P53蛋白、PCNA 表达的阳性检出率及 S-100^+DC 浸润率在高分化(Ⅰ级)病变分别为45.5%(10/22),86.4%(19/22),81.8%(18/22);而在中、低分化(Ⅱ-Ⅲ级)癌组织内则为74.2%(23/31)、87.1%(27/31)、38.7%(12/31)。P53蛋白阳性表达率及细胞密度和 S-100^+DC 浸润率及细胞密度在高分化癌和低分化癌之间均存在着统计学差异(P<0.05);而 PCNA 的表达在两者间无统计学差异(P>0.05)。结论 1.P53基因突变发生于癌变早期(尚未转移),且存在于癌组织由低度向高度恶性病损发展的所有病变中。2.S-100^+DC 浸润率及细胞密度随着 P53蛋白阳性率及细胞密度的升高而降低,这可能反映了在癌基因改变的同时机体免疫功能也受损而降低,从而促进了肿瘤的发展,因而低分化癌症病人临床预后较差。

Objective To investigating the relationship between malignant degree of carcinoma of pancreas head and their molecular biology markers for its fast growth so as to judge their effects on the prognosis of the carcinoma.Methods The expression of p53、PCNA and infiltration rate of S-100^+ dendritic cells(S-100^+DC)in the carcinomas of head of pancreas and its correlation to histological grade were studied in 53 cases by immunohistochemical technique.Results The positive expression of p53, PCNA and infiltration rates of S-100^+DC were 45.5%(10/22),86.4%(19/22),81.8%(18/22)of grade Ⅱ-Ⅲ,respectively.Between grade Ⅰ and grade Ⅱ-Ⅲ,there was a distinctly statistical differ- ence in both the positive rate and cellular density of p53 and S-100^+DC,but there was no statistical dif- ference in expression of PCNA.Conclusions(1)The expression of p53 protein occurs early in process of carcinoma formation and is maintained throughout the progression of carcinoma from low to high grade;(2)Both frequency and cellular density of S-100^+DC infiltration in tumor tissues clearly decline as the frequency of positive expression of p53 and cellular density increase from low to high grade le- sion.The low infiltration rate of S-100^+DC in poorly differentiated lesion may reflect the immunocom- petence of patients is greatly impaired,thus may promote the progression of these tumors and could cause more poor prognosis in patients with high grade carcinomas.