胆囊良恶性病变ki-67和p27表达及其与细胞凋亡的研究

STUDY ON KI-67 AND P27 EXPRESSION AND APOPTOSIS IN BENIGN AND MALIGANT LESIOS OF GALLBLADDER

目的 研究胆囊良、恶性病变中 ki-6 7和 p2 7表达及其与细胞凋亡指数的关系。方法 采用病理组织学观察、免疫组化方法 ( S-P)和原位脱氧核糖核酸末端转移酶标记 ( TUNEL)技术 ,对 5 7例胆囊良、恶性病变进行检测。结果 胆囊壁增厚者粘膜上皮部分或大部分脱失 ,形成代偿性区域性增生集中 ,伴有不同程度的异型性。 ki-6 7在慢性单纯性胆囊炎中阳性细胞数占 5 .1% ,胆囊壁肥厚者占 2 1.2 5 % ,二者的阳性细胞数比较 ,差异有显著性 ( P<0 .0 1)。 p2 7在慢性单纯性胆囊炎中阳性细胞数占 9.4% ,胆囊壁肥厚者 45 .2 % ,胆囊上皮癌变 87.1% ,三者之间的阳性细胞数比较 ,差异有显著性 ( P<0 .0 1)。细胞凋亡指数在慢性单纯性胆囊炎中出现较少 ,并且仅局限在粘膜表面上皮 ,胆囊壁肥厚者细胞凋亡指数增多 ,并呈灶性分布 ,在异型增生 级和癌变的病例中细胞凋亡指数处于不稳定状态 ,但多数病例细胞凋亡指数明显增加。结果显示胆囊腺上皮增生、异型到癌变的过程中 ki-6 7、p2 7的表达和细胞凋亡指数显著相关。结论 胆囊壁肥厚是重要的癌前病变 ,胆囊壁肥厚或增厚的结节在 1.5

Objective To study the ki 67 and p27 expression and apopotic index in benign and malignant lesiens of gallbladder.Methods 57 cases with benign and maligant lesions of gallbladder were detected by histopathology,immunohostochemical staining(S P method) and apoptosis by in situ TUNEL.Results The chronic cholcystitis hyperplastic wall showed part or greater mucosael fall off and accompanied by the dysplasia of local gallbladder gland.The positive cell of ki 67 in the chronic cholcystitis were significantly lower than the cholcystitis hyperplastic wall and gallbladder carcinoma(P<0.01).The apoptosis index of chronic cholcystits appeared low and limited the epideral mucosa.The apoptosis index of cholystitis hyperplastic wall increased and appeared the distribution of the bundle.The apoptosis grade index of the Ⅲ dysplastic hyperplasia and gallbladder carcinoma was not stable increase.The results showed that the ki-67 and p27 expression and apoptosis index are related to the course of the hyperplasia dysplasia-malignant change of gallbladder gland.Conclusion The chronic cholcystits heperplastic-wall is an important precancerous lesions.The hyperplastic-wall or the tuberosity of the thick at exceeding 1.5 cm is practice for radical surgical treatment.