bcl-2、p53蛋白及PCNA表达与横纹肌肉瘤临床病理相关性研究

Study on correlation between expression of oncogene protein products bcl 2, p53 and PCNA and clinicopathology in rhabdomyosarcoma

目的：研究横纹肌肉瘤（ＲＭＳ）中ｂｃｌ－２、ｐ５３、ＰＣＮＡ表达与其临床病理的相关性。方法：对５０例（随访４１例）横纹肌肉瘤进行免疫组化ＡＢＣ法标记。结果：ｂｃｌ－２、ｐ５３基因蛋白和ＰＣＮＡ，发现ｂｃｌ－２、ｐ５３、ＰＣＮＡ阳性表达率分别为２８％、７２％、７０％，其阳性表达与年龄、性别及不同组织类型的ＲＭＳ无关（Ｐ＞０．０５）。但与分化程度有关，ｐ５３、ＰＣＮＡ在低分化ＲＭＳ阳性率分别为８５％、９５％，显著高于高分化ＲＭＳ４２．８％和１４．３％（Ｐ＜０．０５），随访存活１年以内的ｐ５３、ＰＣＮＡ阳性率均为８６．７％，亦明显高于存活超过３年以上的阳性率３３．３％和４１．７％（Ｐ＜０．０５）。而ｂｃｌ－２在低分化ＲＭＳ阳性２０％显著低于高分化７１．４％（Ｐ＜０．０５），随访存活１年以内的阳性率１３．４％明显低于存活超过３年以上的４１．４％（Ｐ＜０．０５）。ｐ５３与ｂｃｌ－２阳性表达呈明显负相关，ｐ５３阳性率越高，而ｂｃｌ－２阳性率越低。结论：ＰＣＮＡ、ｐ５３、ｂｃｌ－２蛋白表达能比较准确地反映ＲＭＳ的生物学特性，ｐ５３、ｂｃｌ－２可作为肿瘤预后显著相关的有效指标。

Purpose In order to study the correlation between expression of oncogene protein products bcl 2, p53, PCNA and clinicopathological features in rhabdomyosarcoma(RMS). Methods 50 cases were stained by immunohistochemical ABC method.Results The positivity rates of bcl 2, p53 and PCNA were 28%, 72% and 70% respectively. These positive expression did not relate to age、sex and histological types, but related to differentiated degree. The positivity rates of p53, PCNA in the poor differentiated RMS was 85% and 95% respectively. While the positivity rate of those in the well differentiated was 42 8% and 14 3% respectively( P <0 05). In one year survivor both p53 and PCNA positivity rates were 86 7% and in more than 3 year survivors p53 and PCNA positivity rates were 33 3% and 41 7% respectively( P <0 05). The positivity rate of bcl 2 in the poor differentiated RMS was 20% while that in the well differentiated RMS was 71 4%( P <0 05). In one year survivor bcl 2 positivity rate was 13 4% and in more than 3 year survivals bcl 2 positivity rate 41 4%( P <0 05). A significant negative correlation was found between bcl 2 and p53 expression. Conclusions PCNA, p53 and bcl 2 may reflect proliferative activity more acurrately and objectively. The p53 and bcl 2 may be considered as prognostic indicators that strongly related to prognosis in RMS.p53 positivity may reflect a poor prognosis,but the bcl 2 positivity may reflect better prognosis.