胆囊癌组织中p21、p53及bcl-2癌基因蛋白的表达及意义

THE EXPRESSION AND SIGNIFICANCE OF P21, P53, BCL 2 ONCOPROTEIN IN GALLBLADDER CARCINOMA

为探讨胆囊良恶性病变组织中ｐ２１、ｐ５３及ｂｃｌ２癌基因蛋白的表达及其与胆囊癌预后的关系，以及在胆囊良恶性病变的鉴别诊断中的作用，采用免疫组织化学ＡＢＣ法，分别测定了４０例胆囊癌及８例胆囊腺瘤型息肉组织中ｐ２１、ｐ５３及ｂｃｌ２癌基因蛋白的表达情况。结果：胆囊癌组织中ｐ２１、ｐ５３及ｂｃｌ２癌基因蛋白表达阳性率分别为５２．５％、５２．５％和７０．０％；在胆囊腺瘤型息肉中３者分别为０％、０％和１００％；其中ｐ５３蛋白表达阳性率在低分化腺癌中明显高于高分化腺癌（Ｐ＜０．０１），ｂｃｌ２蛋白表达阳性率在低分化腺癌中也明显低于高分化腺癌（Ｐ＜０．０１）。本实验结果提示：ｐ２１及ｐ５３蛋白表达可能是胆囊癌预后不良的重要指标，检测ｐ２１、ｐ５３及ｂｃｌ２蛋白表达情况在胆囊癌与胆囊息肉的鉴别诊断中有一定意义。

The expression of p21, p53, bcl 2 oncoprotein was evaluated using immunohistochemistry in 40 patients with gallbladder carcinoma and 8 patients with gallbladder adenomous polyp. In the study, the positive rate of expression of p21, p53 and bcl 2 oncoprotein was 52.5%, 52.5% and 70.0% respectively in gallbladder carcinoma, while, in gallbladder polyp, they were 0%, 0% and 100% respectively. The positive rate of expression of p53 oncoprotein was significantly higher in poor differentiated adenocarcinomas than in well differentiated ones ( P <0.05). The converse was true for bcl 2 oncoprotein. The positive rate of expression of p21 and p53 oncoprotein was significantly higher in metastatic group than in non metastatic one. These results suggest that the patients with the expression of p21, p53 might be of poor prognosis.