P53、Bcl-2在大肠癌中的表达及意义

THE EXPRESSION OF P53,BCL-2 AND ITS SIGNIFICANCE IN THE COLORECTAL CANCER

目的 :研究P5 3、Bcl 2在大肠癌中的表达情况并探讨其与大肠癌生物学行为的关系及其临床和病理意义。方法 :采用免疫组织化学方法SABC法检测具有完整临床资料的 78例新鲜大肠癌手术标本的癌 ,癌旁及其中的 2 6例正常黏膜组织中P5 3、Bcl 2的表达情况 ,同时取 2 9例大肠腺瘤进行P5 3、Bcl 2的测定 ,结合临床病理指标 ,进行统计学分析。结果 :大肠癌、癌旁和正常组织中P5 3阳性表达率分别为 6 6 6 7%、2 9 49%和 0 ,癌、癌旁和正常组织P5 3表达有显著性差异 (P <0 0 5 ) ,癌表达明显高于癌旁表达 (P <0 0 5 )。轻、中、重度不典型增生腺瘤中P5 3阳性表达率分别为 2 5 0 0 % ,6 6 6 7%和 83 33 % ,随着不典型增生程度增加而渐升高。大肠癌、癌旁和正常组织中Bcl 2阳性表达率分别为 5 7 6 9% ,85 90 %和 15 39% ,癌、癌旁表达明显高于正常组织 (P <0 0 5 ) ,癌旁表达明显高于癌表达 (P <0 0 5 )。在不典型增生腺瘤中 ,随着不典型增生程度增加 ,Bcl 2阳性表达率升高 ,但在癌变时又有所下降。重度不典型增生腺瘤中表达为 75 0 0 % ,在癌变时为 5 7 6 9%。Bcl 2阳性表达与大肠癌分化、分期及淋巴结转移无关 (P >0 0 5 )。在腺瘤中 ,P5 3和Bcl 2表达呈负相关 (r = 0 .6 1)。结论 :P5 3和Bcl 2协同作?

Objective:To explore the expression of P53,Bcl 2 in colorectal cancer and determine the relationship with biological behavior and clinico pathological features.Methods:Immunohistochemistry technique,SABC method was used to study the expression of P53、Bcl 2 in 78 cases of colorectal cancer,paracancerous tissues,while 26 cases of normal mucosa were set as contrast.The same detection was carried out in 29 cases of colorectal adenomas.Results:The frequency of P53 expression in colorectal cancer,paracancerous tissues and normal colorectal mucosa was 66.67%,29.49% and zero respectively.Significant difference was found in expression of P53 protein among the groups (P<0 05).The expression of P53 in colorectal cancer was considerably higher than that in paracancerous tissues (P<0 05).The frequency of P53 expression in mild,moderate and severe atypical hyperplasia colorectal adenoma was 25.00%、66.67% and 83.33% respectively.The adenoma with strong P53 expression was often the adenoma with severe atypical hyperplasia.The positive rate of Bcl 2 expression in colorectal cancer,paracancerous tissues and normal colorectal mucosa was 57.69%、85.90% and 15.39% respectively.The expression of Bcl 2 in colorectal cancer,paracancerous tissues was considerably higher than that in normal colorectal mucosa(P<0 05).The expression of Bcl 2 in paracancerous tissues was considerably higher than that in colorectal cancer(P<0 05).The frequency of Bcl 2 expression in colorectal adenomas increased when the degree of atypical hyperplasia was severe,and decreased when it come to adenomas with malignant change.The positive rate of Bcl 2 expression in severe atypical hyperplasia was 75.00%,while Bcl 2 expression in adenoma with malignant change was 57.69%.The Bcl 2 expression was not related to differentiation,Dukes' stage and lymphatic metastasis(P>0 05).P53 expression was negatively correlated with Bcl 2 expression in colorectal adenomas (r=-0.61).Conclusion:P53 and Bcl 2 coparticipate in the occurrence,development of colorectal cancer.P53 expression play an important role in the transformation from benign adenoma to adenocarcinoma.Detection of P53,Bcl 2 and such gene protein related to occurrence of colorectal cancer might be used to early diagnosis of colorectal cancer.Especially,multiple gene detection play an important role in the differential diagnosis of colorectal adenoma and adenoma with malignant change.