胃癌组织中p21、p27、p53和Rb的表达及临床意义

Expression of p21,p27,p53 and Rb proteins and their clinical significance in gastric carcinoma

目的探讨p21、p27、p53和Rb蛋白表达在胃癌发生、发展中的作用。方法应用免疫组化EnVision法检测111例胃癌,38例不典型增生4、7例肠上皮化生2、5例慢性萎缩性胃炎和53例正常胃黏膜组织中p21、p27、p53和Rb蛋白的表达。结果 p21和p27蛋白表达水平在不典型增生组织最高,其次是胃癌组织,与正常胃黏膜组织相比差异均有显著性(P<0.001)。在胃癌组织中p21、p27、p53和Rb蛋白表达均高于正常胃黏膜组织(P均<0.01)。p21、p27蛋白表达与胃癌的类型和分化相关(P均<0.01),p53表达水平与患者的年龄、性别、胃癌的类型和患者的生存率相关。女性患者Rb蛋白表达明显高于男性,差异有显著性(P<0.05)。p21、p27、p53和Rb蛋白表达水平之间均呈正相关。结论 p21、p27、p53和Rb蛋白表达可以作为胃癌的辅助诊断指标,四种蛋白在判断胃癌的生物学行为上具有协同作用。

Purpose To investigate the significance of p21,p27,p53 and Rb protein expression in the pathogenesis of gastric carcinoma.Methods The expression of p21,p27,p53 and Rb proteins was detected in 111 cases of gastric cancer,38 cases of dysplasia,47 cases of intestinal metaplasia,25 cases of chronic atrophic gastritis and 53 cases of normal gastric mucosa by EnVision immunohistochemistry.Results The highest expression level of p21 and p27 protein was observed in the atypical hyperplasia,followed by gastric cancer,and there were significant difference（P0.001）compared with the normal gastric mucosa.The expression of p21,p27,p53 and Rb proteins in gastric cancer was significantly higher than that in normal gastric mucosa（all P0.01）.p21 and p27 protein expression was related to gastric cancer type and differentiation（P0.01）.p53 expression level was related to patient＇s age,sex,tumor type and patient＇s survival rate.Rb protein expression in female patients was significantly higher than that in male patients（P0.05）.Significant correlations were found in the expression of p21,p27,p53 and Rb proteins.Conclusions The expression of p21,p27,p53 and Rb proteins might be a helpful marker for the diagnosis of gastric carcinoma,and these four proteins might play a synergistic role in the evaluation of the biology behavior of gastric carcinoma.