p27蛋白在不同分型腺性膀胱炎中的表达及其临床意义

Expression of P27 in different types of glandularis cystitis and its clinical significance

目的:分析P27蛋白在不同临床分型和病理分型的腺性膀胱炎中的表达,探讨不同分型腺性膀胱炎的恶变可能性,为临床治疗提供依据。方法:对85例腺性膀胱炎组织进行临床分型和病理分型,25例正常膀胱黏膜组织作为对照,应用免疫组织化学(免疫组化)S-P法检测不同类型的腺性膀胱炎组织和正常膀胱黏膜组织中P27蛋白的表达程度,并利用全自动显微镜及图像分析系统对免疫组化染色结果进行图像采集及统计分析。结果:不同临床分型的腺性膀胱炎组织中,乳头型和肠腺瘤型腺性膀胱炎的P27蛋白阳性表达均显著低于正常膀胱组织(P<0.01),而慢性炎症型和滤泡型腺性膀胱炎的P27蛋白阳性表达与正常膀胱组织差异无统计学意义(P>0.05);不同病理分型的腺性膀胱炎组织中,肠化生型和前列腺型腺性膀胱炎的P27蛋白阳性表达均低于正常膀胱黏膜组织(P<0.01),而移行上皮型腺性膀胱炎的P27蛋白阳性表达与正常膀胱组织差异无统计学意义(P>0.05)。结论:临床分型中,乳头型和肠腺瘤型腺性膀胱炎可能为癌前病变;病理分型中,肠化生型和前列腺型腺性膀胱炎可能为癌前病变。对于乳头型和肠腺瘤型腺性膀胱炎伴有肠化生或前列腺上皮化生者,癌变可能大,应积极手术治疗,术后抗肿瘤药物膀胱灌注,并密切随访。

Objective： To analyze the expressions of P27 in different clinical and pathological type of glandularis cystitis,and provide the basis in judging the malignant change of different types of glandularis cystitis. Methods： Eighty-five patients with glandularis cystitis were divided into the different clinical and pathological type,25 normal bladder mucosa tissues were set as the control. The P27 expressions in glandularis cystitis tissue and normal bladder mucosa tissue were detected by immunohistocemistry S-P method,the result of which was analyzed using the automatic microscope and image analysis system. Results： Among the different clinical types of glandularis cystitis tissue,the positive expressions of P27 in nipple and intestinal adenoma type cystitis were significantly lower than that in normal bladder mucosa tissue（ P〈0. 01）. However,the differences of the positive expressions of P27 between chronic inflammatory type,follicular type and normal bladder mucosa tissue were not statistically significant（ P〉0. 05）. Among the different pathological types of glandularis cystitis tissue,the positive expressions of P27 in intestinal epithelial and prostatic intraepithelial neoplasia type cystitis were significantly lower than that in normal bladder mucosa tissue（ P〈0. 01）. However,the difference of the positive expression of P27 between transitional type and normal bladder mucosa tissue was not statistically significant（ P〉0. 05）. Conclusions： In the clinical type,the nipple and intestinal type glandularis cystitis may be precancerous lesion. In the pathological type,the intestinal epithelial and prostate epithelial type of glandularis cystitis may be precancerous lesion. The cancer possibility in patient with nipple and intestinal adenoma type of gladnularis cystitis complicated with intestinal metaplasia of prostate epithelial metaplasia is large,and the patient should be treated with positive operation,bladder instillation and close following-up.