p53、C-erbB-2及nm23在肾盂输尿管癌中的表达特点及其意义

Expression of p53,C-erbB-2 and nm23 in pelvo-ureteral carcinoma and significance

目的:研究p53,C-erbB-2及nm23在肾盂输尿管癌中的表达特点,探讨它们在肾盂输尿管癌发生、进展及预后估计中的意义。方法:利用免疫组化方法检测p53,C-erbB-2及nm23在47例肾盂输尿管癌(其中肾盂癌21例,输尿管癌26例)中的表达情况,并将各指标的表达程度与肿瘤的病理分级及临床分期进行相关性分析。结果:p53、C-erbB-2及nm23阳性表达率分别为72%、64%和62%,p53表达与肿瘤病理分级及临床分期无明显相关性。C-erbB-2表达与肿瘤分级呈正相关,与临床分期无明显相关性。nm23表达与肿瘤分级及临床分期呈负相关。p53与C-erbB-2表达间呈正相关,p53与nm23及C-erbB-2与nm23表达间无相关性。肾盂输尿管癌病理分级与临床分期呈正相关。结论:p53基因突变可能发生在肾盂输尿管癌细胞恶性转化过程中的各个阶段,在肿瘤形成的早期事件及晚期事件中的作用相同。C-erbB-2可能在肿瘤的晚期突变中起到一定的作用,但尚有待进一步研究证实。nm23表达降低是肿瘤恶性程度增高的标志,且与肿瘤的浸润及转移有关,可以做为临床判断肿瘤恶性程度、预后及转归的有价值的参考指标。

Objective：To investigate the characteristics of p53,C-erbB-2 and nm23 expression in pelvo-ureteral carcinoma and discuss its significance in carcinogenesis,development and prognosis of the tumor.Methods：The expression of p53,C-erbB-2 and nm23 in pelvo-ureteral carcinoma of 47 cases（among them,21 cases were pelvic carcinoma and 26 cases were ureteral carcinomas） was evaluated by immuno-histochemistry and made the correlative analysis with pathological grades and clinical stages of the tumor.Results：The positive rates of p53,C-erbB-2 and nm23 were 72%,64% and 62% respectively.p53 expression had no correlation with pathological grade and clinical stage of the tumor.C-erbB-2 expression had positive correlation with pathological grades,but had no correlation with clinical stage.nm23 expression had negative correlation with pathological grade and clinical stage.The expression of p53 and C-erbB-2 had positive correlation,but no correlation was shown between p53 and nm23,C-erbB-2 and nm23.The pathological grade had positive correlation with the clinical stage.Conclusion： p53 mutation may happen in the whole course of the malignant transformation of pelvo-ureteral cell and may have the same effect on both early event and later event of the tumorgenesis.C-erbB-2 may have some effect on the later event of the tumorgenesis which still need further confirmation.Decrease of nm23 expression is a sign of tumor malignancy and is related to tumor invasion and metastasis.nm23 can be used as a helpful parameter to estimate the malignancy、progression and prognosis of the tumor.