细胞周期调节因子在肺结核合并肺癌组织中的表达

The expression of cell cycle regulators in tuberculosis with lung carcinoma

目的探讨细胞周期调节因子在肺结核合并肺癌中的作用。方法LsAB法同时检测69例肺结核合并肺癌患者组织中p53、MDM2、p21ras和p21WAF1蛋白的表达。结果复发癌与原发癌相比:阳性表达率方面,p53蛋白(78%和80%)或MDM2蛋白(84%和83%)很相近,p21ras蛋白(73%和93%)或p21WAF1蛋白(52%和84%)明显下降;高表达率方面,p53蛋白(42%和51%)很相近,MDM2蛋白(57%和32%)明显升高,p21ras蛋白(16%和65%)或p21WAF1蛋白(17%和46%)明显下降。其中,MDM2蛋白表达水平在复发癌明显升高主要见于复发间期<34个月患者组(P<0·05),p21ras蛋白和p21WAF1蛋白表达水平在复发癌明显下降见于复发间期<34个月和≥34个月患者组(均<0·02以下)。结论肺结核合并肺癌,p53蛋白和MDM2蛋白过度表达以及p21WAF1蛋白低表达或不表达可能仍然对肺结核合并肺癌的复发起重要作用;MDM2蛋白表达水平显著升高和p21WAF1蛋白表达水平显著下降可能进一步加促肺结核合并肺癌的过程。

Objective To explore the role of cell cycle regulators in tuberculosis with lung carcinoma. Methods p53, MDM2, p21^ras and p21^WAF1 proteins were detected by LsAB immunohistochemical technique in 69 cases of tuberculosis with lung carcinoma. Results As compared with primary tuberculosis with lung carcinoma, the expression rate p53 or MDM2 protein in relapsing NPC was similar（78% to 80% ,84% to 83% ）,and the expression rate of p21^ras and p21^WAF1 protein in relapsing NPC was obviously descended（73 % to 93% ,52% to 84% ） ;The high-expression rate of p53 protein in relapsing NPC was similar（42 % to 51% ） ,the high-expression rate of MDM2 protein in relapsing NPC was obviously risen（ 57 % to 32 % ）, and the high-expression rate of p21^ras and p21^WAF1 protein in relapsing NPC was obviously descended （ 16 % to 65 %, 17 % to 46 % ）. Among of them, the significant rise of MDM2 protein expression level in relapsing NPC mainly occurred in the patients of group 2 which relapsing-interval was shorter than 34 months（ P 〈 0.05） ;The significant descent of p21^ras and p21^WAF1 protein expression level in relapsing NPC occurred in the patients of group 2 and group 1 which relapsing interval was qual to or longer than 34 months,respectively. Conclusion The overexpression of p53 and MDM2 proteins and the low or negative expression of p21^WAF1 protein after clinical cure might still play an important role in NPC relapse, the obvious rise of MDM2 protein level and the obvious descent of p21^WAF1 protein level might further accelarate the process of tuberculosis with lung carcinoma.