p53蛋白、增殖细胞核抗原在原发性胆囊癌组织中的表达及其临床病理学意义

Clinical Significance of the Expression of p53 and PCNA in Primary Gallbladder Carcinoma and Chronic Cholecystitis

目的：探讨ｐ５３ 蛋白、增殖细胞核抗原（ Ｐ Ｃ Ｎ Ａ）在原发性胆囊癌组织中的表达及临床意义。方法：应用免疫组化 Ｌ Ｓ Ａ Ｂ法，对４６ 例胆囊癌及３０ 例慢性胆囊炎组织中ｐ５３ 蛋白、 Ｐ Ｃ Ｎ Ａ 的表达进行检测。结果：４６ 例胆囊癌组织中ｐ５３ 蛋白、 Ｐ Ｃ Ｎ Ａ 的阳性检出率分别为 ４７．８３％ （２２／４６）和 ６３．０４％ （２９／４６）；３０ 例慢性胆囊炎组织中分别为 ０％ （０／３０）和２３．３３％ （７／３０），癌与炎性病变之间有明显差异（ Ｐ＜ ０．０１）。高分化腺癌ｐ５３ 蛋白、 Ｐ Ｃ Ｎ Ａ 的阳性检出率分别为 ６８．１８％ （１５／２２）和８６．３６％ （１９／２２），明显高于低分化腺癌，二者有显著性差异（ Ｐ＜ ０．０１）。结论：（１）抑癌基因ｐ５３ 突变与 Ｐ Ｃ Ｎ Ａ 过度表达在胆囊癌的发生、发展过程中具有重要作用；（２）ｐ５３ 蛋白、 Ｐ Ｃ Ｎ Ａ 的过度表达与癌组织分化程度有关，可作为临床上判断胆囊癌预后的可靠生物指标。

Objective: To investige the expressions of p53 protein, PCNA (proliferating cell nuclear antigen), and their possible effects on primary gallbladder carcinogenesis. Methods: Expression of p53 protein and PCNA in 46 specimens of patients with primary gallbladder carcinoma and 30 specimens of chronic cholecystitis were detected by LSAB immunohistochemistry. Results: The positive frequency of p53 protein and PCNA immunoreactivity was 47.83%(22/46) and 63.04%(29/46) in tumor tissues respectively, it revealed to be significantly higher than that in inflammatory lesions (0% and 23.33%) (P<0.01). The positive frequency of p53 and PCNA was 68.18%(15/22) and 86.36%(18/22) in high grade cancer tissues, significantly higher than that in low grade cancer tissues (P<0.01). Conclusions: 1. p53 mutation and overexpression of PCNA may have critical effect on primary gallbladder carcinoma. 2. Overexpression of p53 and PCNA was associated with histologic grading of gallbladder carcinomas.