胃癌中P^(53)、P^(21)蛋白表达和PCNA免疫组化及临床病理意义

Immunohistochemistry and its Pathological Significance of P53,P21 Protein and PCNA in Gastric Cancer

应用免疫组化方法及微波修复检测50例胃癌、癌旁粘膜及正常粘膜组织中P53、P21癌基因蛋白及PCNA的表达，探讨其意义。结果表明：癌基因P53、P21及PCNA阳性表达率在癌组织分别为78％（39／50）、95％（47／50）、96％（48／50）；癌旁粘膜分别为42％（21／5O）、18％（9/50）、66％（33／50）呈弱阳性反应；而在正常组织均为阴性0％。P53、P21和PCNA阳性表达与胃癌患者性别、年龄、肿瘤大小、部位、组织学类型无关（P>0．01），而与胃癌浸润深度、分化程度及淋巴结转移都有显著差异（p<0．01）。提示P53、P21癌基因突变及PCNA表达完全正相关。表明P53、P21基因的突变及细胞核增殖均参与胃癌的发生、发展过程。故使用免疫组化加微波修复检测胃癌的P53、P21及PCNA的表达可能成为判断胃癌预后指标，指导患者的临床治疗，同时为早期诊断胃癌提供参考。

Expression of P53,P21 protein and proliferating cell nuclear antigen (PCNA) werestudied by immunohistochemistry and microwave technique in 50 case of gastric carcinomas, mucosanear cancer and normal gastric mucosa. The results showed that positive rates of P53,P21 and PCNAexpression were 78%, 95% and 96% respectively in gastric carcinoma, and 42%, 12% and 66% inmucosa near cancer, while those in normal gastric mucosa expression were 0%. The positive expression of the P53, P21 and PCNA was not correlated with sex, age, tumor sites, large or small andhistological type (P>0.01), and correlated with degree of differentiation of carcinoma and depth ofinvasion and lymph node metastasis (P<0.01). The results suggested that the mutation of P53,P21oncogene and expression of PCNA are involved in the tumorigenesis and development of gastric carcinoma. This study show that the immunohistochemical and microwave technique assay for the oncogene product may prove to be a new tool for the diagnosis of gastric carcinoma.