ΔNp63、Ki-67在膀胱移行上皮癌的表达及意义

The Immunohistochemistry Expressions and Significance of ΔNp63, Ki-67 in the Transitional Cell Carcinoma of Bladder

目的:探讨ΔNp63和Ki-67在膀胱移行上皮癌(transitional cell carcinoma of bladder,TCCB)中的免疫组化表达及与膀胱癌病理分级、临床病理分期和预后的相关性。方法:随机选择2006～2007年间56例TCCB和12例正常膀胱黏膜病理切片用SP免疫组化行ΔNp63和Ki-67检测,将结果与病理分级、分期和预后进行分析。结果:ΔNp63和Ki-67在膀胱移行细胞癌中的阳性表达率明显高于正常膀胱黏膜(P<0.05)。ΔNp63和Ki-67在低分化、浸润性癌组织中的阳性表达率明显高于高分化、浅表性癌组织,在膀胱癌的病理分级和临床分期之间表达差异有统计学意义(P<0.05)。ΔNp63和Ki-67在复发病例中的阳性表达率显著高于初发病例(P<0.05)。采用Spearman等级相关性分析对ΔNp63和Ki-67在TCCB中的表达进行比较,ΔNp63与Ki-67呈正相关,rs′为0.316,且P<0.05。结论:ΔNp63和Ki-67与膀胱癌的临床病理分级和分期及预后密切相关,随膀胱癌分化程度的降低和浸润程度的增加而增强。ΔNp63和Ki-67在TCCB的进展中可能有相互协同作用,ΔNp63可能通过促进细胞增殖发挥促癌作用,联合检测ΔNp63和Ki-67可以作为判断TCCB的预后的肿瘤标记物。

Objective： To evaluate the immunohistochemistry expressions of ΔNp63, Ki-67 in the transitional cell carcinoma of bladder （TCCB） and the relationship between the expressions of ΔNp63, Ki-67 and the pathological stage, grade and prognosis of bladder cancer. Methods： Fifty-six cases with complete clinical data were selected from the year of 2006 to 2007, whose diagnosis was confirmed by surgery; the expressions of ΔNp63 and Ki-67 on these pathological sections were detected by immunohistochemical staining. The immunoassay results were analyzed in relation to the tumor stage, grade and compared them with the clinical parameters of prognosis. Spearman rank correlation was used to compare and analyze two markers expression in the bladder cancer. Results： Among 56 sample cases of TCCB, the expressions of TCC-positive rate of ΔNp63, Ki-67 were higher than the cell of normal bladder mucous membrane （P〈0. 05）. The results showed that the expressions of TCC-positive rate of ΔNp63 and Ki-67 in the poorly differentiated and invasive TCCB were significantly higher than the well differentiated and superficial TCCB. The expression difference of the two markers between the pathology grade and clinical stage had statistical significance. The expressions of TCC-positive rate of ΔNp63, Ki-67 in the recurred cases were much higher than the primary cases （P〈 0.05）. ΔNp63 and Ki-67 showed positive correlation, the rs＇ was 0. 316, rank correlation had statistical significance （P〈0.05）. Conclusion： Abnormal expressions of ΔNp63 and Ki-67 is obviously correlated with the pathological grade and clinical staging and prognosis of bladder cancer, and it increase with the degree of the lower level of the tumor cell differentiation and the degree of the higher level of the tumor eell invasion. ΔNp63 and Ki-67 may have mutual synergy in Progress of TCCB, ΔNp63 may play a role in tumor promotion by promoting cell proliferation. The combined detection of ΔNp63 and Ki-67 can be used as to determine the prognosis of TCCB tumor markers.