胆囊腺瘤细胞中survivin与P53蛋白定位表达及其病理意义

Expression of survivin and p53 protein localization in the gallbladder adenoma cells and its pathological significance of

目的:观察Survivin以及P53蛋白在胆囊腺瘤以及胆囊腺癌细胞中的形态特点以及定位表达,探析其在病理和鉴别诊断中的临床意义。方法:选择2011年3月～2012年7月我院30例胆囊腺瘤以及60例胆囊腺癌患者为研究对象,采用免疫组化法对患者腺瘤和腺癌细胞中Survivin和P53蛋白的表达进行检测,分析其所具有的病理意义。结果:30例胆囊腺瘤患者中,P53在胆囊腺瘤中无表达,28例患者Survivin蛋白表达于细胞浆内,阳性率为93.33%,其中25例患者表达于细胞核上,包括21例"核上核样"和3例"核上泥沙样"以及1例弥漫表达于细胞浆;在60例胆囊腺癌患者细胞中46例P53蛋白表达于细胞核内,在核内的表达率为76.67%,44例患者Survivin蛋白在细胞浆内呈弥漫性表达,阳性率为73.33%,Survivin蛋白在胆囊腺癌和胆囊腺瘤中表达的阳性率存在显著差异(P<0.05),同时其形态特征以及表达的部位也具有明显的差异(P<0.05)。结论:Survivin蛋白在胆囊腺瘤组织中呈"核上泥沙样"和"核上核样"表达,且特异性较强,是临床诊断胆囊腺瘤的一种特异性抗体,与P53蛋白在胆囊腺瘤患者组织中无表达,在胆囊癌组织细胞核中呈阳性表达的结果进行结合分析,构成了两种蛋白在分子形态学上表达的差异,是临床上病理鉴别诊断胆囊腺癌和胆囊腺瘤的一种比较可靠的分子学方法,并结合病理HE切片,能基本解决临床上对胆囊癌和胆囊腺瘤的相关病理诊断以及鉴别诊断的问题。

Objective： To observe the morphological characteristics and expression of the Survivin and P53 protein in gallbladder adenoma andl gallbladder adenocarcinoma cells in order to analyze its sigriificance in pathology and differential diagnosis of the two diseases. Methods： Thirty cases of gallbladder adenoma and 60 cases of gallbladder adenocarcinoma admitted to our hospital during March 2011 to July 2012 were enrolled, expression of Survivin and P53 protein were detected with immunohistoehemical methods. Results： The test results showed that 30 cases of gallbladder adenoma patients,No expression of P53 were observed in 30 gallbladder adenoma cases, but for 28 cases Survivin protein expression were observed in cytoplasm, the positive rate was 93.33 %, of which 25 patients showed expression in the nucleus including sediment samples in the 21 cases of ＂nuclear-like＂ and 3 cases of ＂nuclear＂ and one cases of diffuse expression in the eytoplasm; P53 protein expression were observed in the nucleus for 46 of the 60 gallbladder adenocarcinoma cases, and the nuclear expression rate was 76.67%, in 44 gallbladder adenocarcinoma cases, Survivin protein showed diffuse expression in the cytoplasm, the positive rate was 73.33%. The positive expression rate as well as expression location and morphological characteristics of survivin protein in gallbladder adenocareinoma and gallbladder adenoma cases were all significant different （Pall〈0.05）. Conclusion：Survivin protein expression in gallbladder adenoma tissue is ＂nuclear＂ or ＂nuclear nuclear-like＂ showing specific morphologic characters, and is a specific antibody for the diagnosis of gallbladder adeno- ma; P53 expression is not observed in gallbladder adenoma tissues, but it＇s positively expressed in gallbladder carcinoma tissues. The morphologic characters of P53 and Survivin protein express combining with pathological HE examination provide a reliable way to differentiate the two kinds of diseases.