增殖细胞核抗原和p53蛋白在胆囊癌中的表达

Expression of PCNA and p53 Protein in Gall Bladder Epithelical Benign Lesion and Carcinomas

本文应用PCNA和p53抑癌基因蛋白的免疫络化方法，对11例胆囊上皮良性病变和33例胆囊癌进行了研究，结果发现胆囊良性病变和胆囊癌的平均PCNA指数分别为：良性病变为24．1％（n＝11．x±24．6），高分化癌为48．0％（n＝13，x±12．8），中分化癌为49．5％（n＝11，x±15．4）．低分化癌为76．4％（n＝9，x±18．1）；高分化胆囊癌平均PCNA指数明显高于良性病变（P＜0．05）；低分化癌的平均PCNA指数明显高于高分化癌（P＜0．05）；11例胆囊上皮良性病变均无p53蛋白阳性表达；33例胆囊癌p53阳性表达12例（36．4％），高分化癌p53阳性率为15．4％（2／13）．中分化癌45．5％（5／11）．低分化癌55．6％（5／9）：各组阳性率比较无显著性差异（P＞0．05）；PCNA指数≥50％的胆囊癌其p53蛋白阳性率明显高于PCNA指数＜50％的胆囊癌（P＜0．05）。结果提示：PCNA指数与胆囊癌的分化程度有关．PCNA及p53蛋白的免疫组化染色对胆囊上皮良、恶性病变的鉴别论断有帮助。本文还就胆囊癌p53蛋白表达与PCNA指数的关系进行了讨论。

Thirty-three cases of gall bladder carcinomas and eleven cases of gall bladder-epithelial benign lesions were studied byp53 protein and PCNA with imrnunohisto-chemical method. The results showed that the mean PCNA index vatue among the benign le-sion,well-differentiated carcinorna, middle-differentiated carcinorna and poor-differentiated carcinoma was 24. 1% 58 (n = 11, x ± 24. 6 ),48. o% (n= 13, x ± 12. 8),49. 5% (n= 11, x ± 15. 4), 76. 4 % (n = 9. x ± 8. 1) respectively. There was significantly different (P <0. 05 ) between the benign lession and well-differentiated carcinoma. and there was also significantly different (P< 0.05 ) between thewell-differeniated carcinorna and poor-differentiated carcinoma. No Positive-p53 protein expression wils found in al1 eleven cases of gallbladder epitheliaI benign lesions, but tweIve cases out of 33 adencarcinomas were found to be p53 positive. 15. 4 % of the well-differenti-ated, 45. 5 % of the rniddle-differentiated and 55. 6% of the poor-differentiated carcinorna were found to be p53 positlve. The positiverate fo p53 protein in carcinomas with PCNA index >50% was significantly higher than that in carcinornas with PCNA index <50 %(P< 0. 05 ). Our findings suggest that PCNA index are associated with the grade of differentiation in gall bladder carcinornas. PCNAand p53 staining are useful for differential diagnosis belween the gall bladder benign lession and carcinoruas. The relationship of PCNAindex and p53 protein expression in carcinornas are aIso discussed.