抑癌基因p16和p53在膀胱癌中的表达及意义

The Expression of p16 and p53 Tumor Suppressor Gene in Bladder Carcinoma

目的 研究膀胱癌中抑癌基因 p16和 p5 3的表达及其与临床病理特征及预后的关系。 方法 应用免疫组织化学ABC法和微波炉抗原修复法对 6 9例膀胱移行细胞癌标本中抑癌基因p16和突变型p5 3蛋白产物进行检测。结果 6 9例膀胱癌标本中 37例p16检测阳性 (5 3.6 2 % ) ,30例 p5 3检测阳性 (43.48% )。p16阳性率在Ⅰ、Ⅱ和Ⅲ级肿瘤中分别为 6 9.5 7%、5 6 .2 5 %和 2 1.43% ,在Tis～T1期和T2 ～T4 期肿瘤中分别为 70 .5 9%和 37.14%。p5 3阳性率在Ⅰ、Ⅱ和Ⅲ级肿瘤中分别为 2 6 .0 9%、46 .88%和 6 4.2 9% ,在Tis～T1期和T2 ～T4 期肿瘤中分别为2 9.41%和 5 7.14%。随着膀胱癌病理分级、临床分期的上升 ,p16表达阳性率逐渐下降 ,p5 3阳性率逐渐上升。p16阴性或 p5 3阳性患者的肿瘤复发率和病死率分别高于p16阳性或 p5 3阴性患者。 结论 p16和p5 3的表达状况与膀胱癌生物学行为密切相关。p16和 p5 3的免疫组化检测具有评估膀胱癌预后的价值 ,可作为膀胱癌的生物学瘤标。

Objective To understand the relation between the expression of p16, p53 and the cli nical patholoty and prognosis in transitional cell carcinoma of the bladder.Methods Protein products of p16 and p53 were detected by immunohistochemical method (ABC method)and repairing method of antigen with microwave oven in 69 specimens of transitional cell bladder carcinoma.Results The p16 was positive in 37 of 69 (53.62%)and p53 positive in 30(43.48%).The p16 positivity rate in grade Ⅰ ,Ⅱ and Ⅲtumors was 69.57%,56.25% and 21.43% respectively and in stage Tis～T 1 and T 2～T 4 tumors 70.59% and 37.14%.The p53 positivity rate in grade Ⅰ,Ⅱand Ⅲ tumors was 26.09%,46.88% and 64.29% respectively and in stage Tis～T 1 and T 2～T 4 tumors 29.41% and 57.14%. The p16 positivity rate was significantly lower in patients with poorly differentiated and invasive bladder cancer, but p53 positivity rate significantly higher in patients with poorly differentiated and invasive bladder cancer. The recurrence and death rates in p16 negative group or p53 positive cases were higher than those in p16 positive group or p53 negative cases respectively.Conclusion The expression of p16 and p53 reflects the biological malignancy of transitional cell bladder carcinoma. Immunohistochemecal analysis of p16 and p53 has prognostic value in bladder cancer and could be used as tumor markers for bladder cancer.