早期胆囊癌癌基因的表达

Expression of oncogene in early gallbladder cancer

目的：研究从慢性胆囊炎，胆囊腺瘤至早期胆囊癌等多阶段发展过程中多种癌基因变化，进一步探讨胆囊癌的发病机理，寻找胆囊癌早期诊断的肿瘤标志物。方法：采用免疫组织化学Ｓ－Ｐ法检测慢性胆囊炎、胆囊腺瘤及早期胆囊癌的ｎｍ２３、ｐ５３、ｒａｓ、ｃ－ｍｙｃ、ｃ－ｅｒｂＢ－２等癌相关基因蛋白的表达。结果：①ｎｍ２３、ｐ５３、ｃ－ｍｙｃ、ｒａｓ及ｃ－ｅｒｂＢ－２基因在胆囊腺瘤及早期胆囊癌中有表达；②着色强度随病变发展逐渐增强；③２例胆囊腺瘤伴不典型增生呈强阳性表达；④ｐ５３基因仅见于早期胆囊癌；⑤联合癌基因ｐ５３、ｒａｓ，ｐ５３、ｃ－ｍｙｃ，ｐ５３、ｃ－ｅｒｂＢ－２及ｐ５３、ｒａｓ、ｃ－ｍｙｃ对诊断早期胆囊癌有价值。结论：ｐ５３，ｒａｓ，ｃ－ｍｙｃ及ｃ－ｅｒｂＢ－２可能与胆囊癌的发生有关，四者在胆囊癌的发生中可能起协同作用。

Purpose To study change of many oncogenes in many duration, development process from chronic cholecystitis, adenoma to early gallbladder cancer. Discussing pathogenesis of gallbladder cancer and finding tumor marker for diagnosis early gallbladder cancer. Methods Using SP immunohistochemical method for studying the expressions of oncogene protein products nm23, p53, ras, cmyc and cerbB2 in chronic cholecystitis, adenoma and early gallbladder cancer. Results The results showed that there were positive expressions of nm23, p53, ras, cmyc and cerbB2 in adenoma and early gallbladder cancer and positive grade increased with disease developed. Two adenomas with dysplasia were higher positive expressed and positivity of p53 was only seen in early gallbladder cancer. There was a diagnosis value for early gallbladder cancer with coexpression of p53+ras, p53+cmyc, p53+cerbB2, and p53+ras+cmyc. Conclusions These results indicate that p53, ras, cmyc and cerbB2 are related with gallbladder carcinoma occurring. They may play a combined role in gallbladder carcinoma occurring. 