结肠上皮肿瘤P^(53)蛋白表达及其临床意义的研究(英文)

Expression and clinical significance of P^(53) protein in colorectal tumors

目的 对正常结肠粘膜上皮 ,结肠上皮增生样息肉 ,结肠上皮腺瘤和结肠腺癌组织中P53 蛋白的表达进行了检测 ,并对其临床意义进行评估。方法 应用单克隆抗体DO - 7,采用免疫组织化学LSAB方法 ,对 7例结肠增生性息肉、5 9例结肠腺瘤 ( 2 6例管状腺瘤、13例混合状腺瘤、2 0例绒毛腺瘤 )和 30例结肠腺癌组织中P53 蛋白进行标记。结果 正常结肠上皮及增生性息肉组织中P53 蛋白标记阴性。结肠腺瘤和结肠腺癌组织中P53 表达阳性率明显增多差异有显著意义 (P <0 0 1)。结肠癌中P53 阳性率达 5 6 6 7% ,并与结肠癌的分化程度及临床Dukes分期有关 ,分化程度越高 ,P53 表达率越低。DukesA期结肠癌P53 表达率明显低于DukesD期 (P <0 0 5 )。结肠癌存活率随着P53 阳性率和阳性标记范围的增加而降低。标记范围大于 6 0 %者存活率明显低于标记范围小于 2 5 %者 (P <0 0 5 )。这也符合临床中DukesD期患者 5a存活率明显低于DukesA期患者的现象。在结肠腺瘤中 ,P53 阳性率与腺瘤的大小和是否伴有异型增生有关 ,腺瘤直径≥ 2 0mm者阳性率明显高于直径 <10mm者 (P <0 0 5 )。P53 蛋白表达随异型增生程度的增加而增加 ,重度异型增生和息肉癌变组织中P53 阳性率明显高于轻度异型增生腺瘤 ( P <0 0 5 ,P <0 0 5 )。

Objective To study expression of P 53 protein in colorectal adenoma and carcinoma and to evaluate its clinical significance.Methods Using the monoclonal antibody DO-7, the p 53 protein was detected in 59 cases of colorectal adenoma (26 tubular, B tubulovillous, 20 villous),30 cases of colorectal carcinoma and 7 cases of proliferativepolyp by immunohistochemical staining. Results The p 53 positive rate was significantly higher in adenoma and carcinoma than in the normal (P<0.01). P 53 protein was not observed in proliferative polyps and normal mucosas.The P 53 protein expression rate was 56.67 percent in colorectal carcinomas. In colorectal adenoma, P 53 expression increased with increaseing of size and degree of dysplasia,which was higher in adenomas sized ≥20 mm than in that sized <10 mm(81.82% vs 35.71%, P<0.05). P 53 protein expression was seen often in villous adenomas (P<0.05). As the degree of dysplasia increased, the frequency and P 53 protein expression rate also increased. Expression of P 53 protein was also related to differentiation degree and Dukes stage (P<0.05). P 53 positive rate, with a significant negative correlationship (>60 percent group vs≤25 percent group, P<0.05).Conclusions The P 53 protein is related to development of colorectal adenoma and carcinoma, and plays an important role in clinical diagnosis and prognostic evaluation. The assay of P 53 protein expression in colorectal adenoma is helpful to early detection of colorectal adenocarcinoma.