胃癌、癌前病变组织中p53蛋白表达的临床意义

The Clinical Significance of p53 Protein Expression in Gastric Carcinoma and Precancerous Lesions

目的 探讨胃癌及癌前病变组织中p5 3蛋白表达的临床意义。方法 采用间接免疫荧光标记染色和流式细胞术 ,检测并比较 10例正常胃粘膜、13例浅表性胃炎、10例肠上皮化生、11例不典型增生及 16例胃癌组织中 p5 3蛋白的表达水平。以DNA指数、增殖指数 (PI)、荧光指数 (FI)为分析指标。结果 胃癌、不典型增生及肠上皮化生的FI值分别为 1.86 6± 0 .0 96、1.14 3± 0 .0 6 0、1.0 5 0± 0 .0 74,与正常胃粘膜 ( 0 .6 0 2± 0 .0 77)比较 ,均有显著性差异 (P <0 .0 5 ) ,与浅表性胃炎 ( 0 .898± 0 .0 5 2 )比较 ,也有显著性差异 (P <0 .0 5 )。胃癌组织的FI值高于不典型增生及肠上皮化生 (P <0 .0 5 )。不典型增生组织 p5 3蛋白阳性率为 2 5 .0 %( 2 /8) ,胃癌为 6 8.4% ( 13/19) ,在不典型增生及胃癌组织中 ,其异倍体的FI值、PI值和p5 3蛋白阳性率与二倍体者比较 ,均有显著性差异 (P <0 .0 5 )。结论 胃癌组织 p5 3蛋白的表达水平高于癌前病变及正常胃粘膜组织 ;随病变向恶性转化 ,p5 3蛋白表达水平、PI值及异倍体率均增高。因此 ,检测 p5 3蛋白表达水平对胃癌的诊断具有一定意义。

Objective To detect and compare the levels of p53 protein expression in gastric carcinoma and precancerous lesions,and investigate the significance of p53 protein in the pathogenesis of the diseases.Methods Indirect immune fluorescent labeling and flow cytometry were employed.DNA index,proliferation index and fluorescence index were used as basic data for statistical analysis.Results Statistical analysis showed that FI values were higher in gastric carcinoma,dysplasia and metaplasia than in the tissues of normal gastric mucosa and superficial gastritis(P<0.05).At the same time,it was also observed that there were higher FI values in gastric carcinoma than both in metaplasia and in dysplasia(P<0.05).Positive p53 protein expression accounted for 25.0% of dysplastic cases and 68.4% of gastric carcinoma.As to the relationship between DNA ploidy and p53 protein expression it was seen that PI,FI and p53 positive rate were significantly higher in aneuploidy cases than in diploidy one(P<0.05).Conclusion Detection of p53 protein expression may contribute to appreciating gastric carcinoma.It may act as a reference index in making the diagnosis of gastric carcinoma.