膀胱移行细胞癌组织中hTERT和p16,cyclinD_1,RB的表达及意义

Clinical Significance of hTERT and p16,CyclinD_1,Rb Expression in the Transitional Cell Carcinoma of Urinary Bladder

目的探讨膀胱移行细胞癌组织中端粒酶逆转录酶(human telomerase reverse transcriptase,hTERT)与p16,cyclinD1,RB基因的表达关系及其意义,为膀胱移行细胞癌的早期诊断、临床治疗及预后随访提供更确切的理论依据。方法采用实时荧光定量RT-PCR检测55例膀胱移行细胞癌组织、28例癌旁组织及9例正常膀胱组织中hTERT基因的表达情况;免疫组织化学方法(S-P法)检测55例膀胱移行细胞癌组织中p16,cyclinD1,RB基因的表达情况,并结合临床资料分析评价上述基因表达与膀胱移行细胞癌临床生物学行为的关系。结果55例膀胱移行细胞癌组织中hTERT的表达与p16之间未发现相关性,而与cyclinD1呈正相关(r=0.385,P=0.040);与RB呈显著负相关(r=-0.318,P=0.018)。p16与cyclinD1,RB表达呈显著负相关(r分别为-0.301和-0.279,P<0.05)。结论膀胱移行细胞癌组织中hTERT与cyclinD1的表达有较好的协同性;hTERT和p16,cyclinD1,RB的表达均与临床分期相关,上述基因的改变可能在膀胱移行细胞癌的发生和发展过程中有重要作用,它们的联合检测对膀胱癌的诊断治疗和预后评价有重要意义。

Objective To explore the correlation and clinical significance of human telomerase reverse transriptase （hTERT） and p16, cyclinD1, RB expression in the transitional cell carcinoma of urinary bladder（ BTCC）. Methods Using real-time quantitative RT-PCR, we examined hTERT in 55 cases of BTCC treated by cystectomy and TURBt,28 eases of adjacent normal tissue and 9 cases of normal bladder tissue. Using immunohistochemistry, we examined fur loss of Rb or p16 protein and for cyelinD1 protein overexpression in 55 cases of BTCC and evaluated the correlation between these gene expressions and the biological behaviour of BTCC, also the relation among these genes, Results A significant positive correlation was observed between hTERT and cyclinD1 （r = 0. 385, P = 0. 040）. There was no significant association hetween the expression of hTERT and p16 （ P 〉 0. 05）. A significantly inverse correlation was observed between the expression of hTERT and RB （ r = -0. 318, P = 0. 018）, p16 and cyclinD1 （r= -0.279, P=0.039） ,also between p16 and RB （r= -0.301,P=0.025） .Conclusions There is a good relationship between the expression of p16, cyclinD1 anti RB, therefore it may be helpful in diagnosis of BTCC to examine them simultaneously, It is suggested that expression of hTERT and the abnormality of p16/RB pathway may play an important role in the genesis and malignant progression of BTCC.