大肠癌P53蛋白PCNA和CEA的表达与淋巴结转移的关系

Relationship between expression P53 protein, PCNA and CEA in colorectal cancer and lymph node metastasis

目的研究大肠癌Ｐ５３蛋白、增殖细胞核抗原（ＰＣＮＡ）和ＣＥＡ的表达与淋巴结转移的关系．方法应用链霉菌素生物素（ＳＰ）免疫组化法，观察４４例大肠癌Ｐ５３，ＰＣＮＡ的阳性率和ＣＥＡ的表达型式．结果大肠癌Ｐ５３阳性率为５２３％；大肠癌Ｐ５３阳性表达与性别、年龄及肿瘤的部位、分化程度和浸润深度无关（Ｐ＞００５）；大肠癌Ｐ５３阳性者其淋巴结转移率较阴性者高（１４／２３，６０９％ｖｓ６／２１，２８６％，Ｐ＜００５）；Ｐ５３阳性表达及有淋巴结转移者其细胞增殖活性分别较Ｐ５３阴性表达及无淋巴结转移者高（５５９±１７ｖｓ３７９±１４，Ｐ＜００５；５６２±１５ｖｓ３９６±１７，Ｐ＜００５）；Ｐ５３阳性表达及有淋巴结转移者其ＣＥＡ表型均以胞质型和间质型为主（２１／２３，９１３％ｖｓ１３／２１，６１９％，Ｐ＜００５；１９／２０，９５０％ｖｓ１５／２４，６２５％，Ｐ＜００５）．结论检测Ｐ５３和ＰＣＮＡ表达及ＣＥＡ表型对判断大肠癌的恶性程度，预测其淋巴结转移趋势和预后及指导临床治疗有重要价值．

AIM To study the P53 protein, PCNA and CEA expression and its relationship with lymph node metastasis in colorectal cancer. METHODS SP immunohistochemical method was used to examine the positive rates of P53 protein, PCNA and the phenotype of CEA in 44 cases of colorectal cancer. RESULTS The positive rate of P53 protein expression in colorectal cancer was 52 3%, which was not related to sex, age, tumor location, differentiation or invasion ( P >0 05). The frequency of lymph node metastasis in P53 positive cases was significantly higher than in P53 negative cases (14/23, 60 9% vs 6/21, 28 6%, P <0 05). The cell proliferative activity in P53 positive and nodal metastasis cases were markedly higher than in P53 negative and non nodal metastasis cases (55 9±1 7 vs 37 9±1 4, P <0 05;56 2±1 5 vs 39 6±1 7, P <0 05). The phenotype of CEA in both P53 positive and nodal metastasis cases was mainly the cytoplasm and stroma patterns (21/23, 91 3% vs 13/21, 61 9%, P <0 05;19/20, 95 0% vs 15/24, 62 5%, P <0 05). CONCLUSION P53, PCNA and CEA expression is important to determine the degree of malignancy and prognosis, and pre dict lymph node metastasis of colorectal cancer.