p53、BCL-2在肠癌癌前病变中的表达及意义

The expression and significance of p53 and BCL-2 proteins in colorectal carcinoma and precancerous lesion

目的:研究p53、BCL-2蛋白在肠癌及癌前病变中的表达与肠癌生物学行为的关系。方法:采用免疫组化二步法,检测p53、BCL-2蛋白在90例肠癌、40例异型增生和20例正常肠黏膜中的表达。结果:p53在正常肠黏膜中不表达,异型增生肠组织中表达率为25%,且随肠黏膜异型增生程度的加重而增高,在肠癌中表达率为62.2%。BCL-2蛋白在肠癌表达率为50%,异型增生表达率为47.5%,在正常肠黏膜几乎不表达。BCL-2蛋白的表达与肠癌分化程度成正相关(P<0.05),与淋巴结转移、肿瘤浸润深度无关(P>0.05);p53蛋白阳性表达与淋巴结有无转移有统计学意义,但与肿瘤的分化程度及浸润深度无关;5年生存率在p53蛋白阳性表达、阴性表达两组之间的差异有统计学意义。结论:p53、BCL-2蛋白的表达与肠癌癌前病变及肠癌密切相关,联合检测p53、BCL-2可以作为肠癌早期诊断及评估预后的参考指标。

Objective：To explore the relationship between the expression of p53,BCL-2 proteins and the biological behavior of colorectal carcinoma.Methods： Expressions of p53 and Bcl-2 proteins in 20 cases of normal colorectal mucosa,40 samples of colorectal intraepithelial replasia and 90 samples of colorectal adenocarcinoma were detected by immuno-histochemical staining Sp-method.Results： There was no expression of p53 in normal colorectal mucosa.The positive expression rate of p53 in colorectal intraepithelial neplasia was 25%,and in colorectal aderocarcinoma was 62.2%,The rate increased gradually when the grade of intraepithelial neplasia got serious.The positive expression rate of BCL-2 in colorectal carcinoma was 50%,and in intraepithelial neplasia was 47.5%,there was no expression of BCL-2 in normal colorectal mucosa.The expression of BCL-2 was related with the differentiation degree of colorectal carcinoma（P0.05）.but was not related with the depth of infiltraction and lymph node metastasis of colorectal adenocarcinoma（P0.05）.There was statistical significance between the expression of p53 and lymph node metastasis,but not related with the depth of infiltraction and the differentiation degree.The difference of the 5-years survival rate between the two groups which had positive or negative result in the expression of p53 protein had statistical significance.Conclusion： The expression of p53and BCL-2 was associated with colorectal carcinoma and precancerous lesion,so they might be used as reference factors for the prognosis of colorectal carcinoma.