不同部位恶性黑色素瘤DNA倍体分析和PCNA、p53蛋白的表达及其意义

DNA ploidy,PCNA and p53 protein expression in malignant melanoma of different sites and their significance

目的对不同部位恶性黑色素瘤(malignantmelanoma,MM)的DNA倍体、PCNA阳性指数及p53蛋白的表达作对比性分析,探讨其与预后的关系。方法31例MM按部位、临床复发情况分为眼球脉络膜组、皮肤组、中轴腔黏膜组及复发组,对它们进行激光扫描细胞术DNA倍体分析、PCNA和p53蛋白表达的检测,结合随访,作各组间比较。结果PCNA阳性百分率在脉络膜MM中最低,其次为皮肤MM,中轴腔黏膜MM更高,复发组最高,各组间差异有显著性(P<0.01);各组死亡率也呈同样增长趋势;异倍体在前两组中发生率低,而在后两组中各占50%。绝大多数MM不表达p53蛋白,仅在部分复发MM中可检测到p53。结论不同部位MM的PCNA指数、异倍体比例及存活率是不同的,它们之间有一定关联;复发的MM中PCNA指数、异倍体的比例最高,并表达p53蛋白。测定PCNA和异倍体对判断MM的预后有意义。

Purpose To comparatively study DNA ploidy and expression of PCNA and p53 protein in malignant melanoma （MM） of different sites and different clinical stages, in related with survival condition. Methods 31 cases of MM were divided into four groups： uveal, cutaneous, axial mucosal and recurrent groups. DNA ploidy was analyzed by laser scanning cytometry, and expression of PCNA and p53 protein was detected by immunohistochemistry. Combined with follow-up data, comparison among the groups was carried out. Results There were significant differences in PCNA expression among the four groups（P〈0.01） ;recurrent group had a highest PCNA index, followed by axial mucosal and cutaneous groups; the uveal group was revealed to have the lowest PCNA index. Survival rate showed a close relation with the PCNA index. DNA aneuploidy was fewer in uveal and cutaneous groups and more in axial mucosal and recurrent groups. In most of cases, the tumor cells did not express p53 protein except the cases in recurrent group. Conclusions PCNA expression, anueploidy and survival rate are different in MMs of different sites, and related with each other. PCNA index and DNA content analysis may have prognostic significance in MMs.