初发与复发胶质瘤组织中细胞周期蛋白D1和细胞周期蛋白依赖性激酶4及P16蛋白表达差异及意义

Expressions and significances of cyclin D1,cyclin-dependent kinase 4 and P16 in primary and recurrent glioma tissues

目的探讨胶质瘤患者初发、复发手术切除组织中细胞周期蛋白D1(cyclin D1)、细胞周期蛋白依赖性激酶4(cyclin-dependent kinase 4,CDK4)、P16蛋白表达差异及临床意义。方法胶质瘤患者75例,初诊后行手术治疗,随访复发后再行手术治疗。取初发及复发后手术切除标本,采用免疫组织化学法检测cyclin D1、CDK4及P16蛋白阳性表达。结果初发、复发胶质瘤组织cyclin D1、CDK4、P16蛋白阳性表达率在性别、年龄、病理类型上比较差异均无统计学意义(P>0.05);初发胶质瘤组织cyclin D1、CDK4蛋白阳性表达率在Ⅰ～Ⅱ级(22.5%、47.5%)低于Ⅲ～Ⅳ级(57.1%、82.9%)(P<0.05);复发胶质瘤组织cyclin D1蛋白阳性表达率在Ⅰ～Ⅱ级(38.1%)低于Ⅲ～Ⅳ级(70.4%)(P<0.05);初发胶质瘤组织cyclin D1、CDK4阳性表达率(38.7%、64.0%)低于复发胶质瘤组织(61.3%、80.0%),P16蛋白阳性表达率(78.7%)高于复发胶质瘤组织(62.7%)(P<0.05)。结论胶质瘤复发后cyclin D1、CDK4表达率增高、P16蛋白表达率降低提示恶性程度增高,侵袭性增加,预后不良。

Objective To investigate the expressions and significances of cyclin D1,cyclin-dependent kinase 4（CDK4）and P16 in primary and recurrent glioma tissues.Methods Seventy-five patients with glioma underwent operation after initial diagnosis,and reoperation after recurrence during follow-up survey.The expressions of cyclin D1,CDK4 and P16 in primary and recurrent glioma tissues were detected by immunohistochemistry.Results The positive expression rates of cyclin D1,CDK4 and P16 proteins in primary and recurrent glioma tissues showed no significant differences in the gender,age and pathological type（P〉0.05）.The positive rates of cyclin D1 and CDK4 in primary glioma tissues were significantly lower in grade Ⅰ-Ⅱ（22.5%,47.5%）than those in grade Ⅲ-Ⅳ（57.1%,82.9%）（P〈0.05）.The positive rate of cyclin D1 protein in recurrent glioma tissues was significantly lower in gradeⅠ-Ⅱ（38.1%）than that in grade Ⅲ-Ⅳ（70.4%）（P〈0.05）.The positive rates of cyclin D1 and CDK4 were significantly lower in primary glioma tissues（38.7%,64.0%）than those in recurrent glioma tissues（61.3%,80.0%）,and the positive rate of P16 was significantly higher in primary glima tissues（78.7%）than that in recurrent glioma tissues（62.7%）（P〈0.05）.Conclusion The elevated levels of cyclin D1 and CDK4 and decreased level of P16 in recurrent glioma tissues indicate the increased degree of malignancy,increased invasiveness and poor prognosis.