Ki67、P53及微血管密度在大肠肿瘤中的表达

Expression of Ki67,P53 Microvessel Density in Human Colorectal Tumor

目的 研究Ki67、P53及微血管密度(microvessel density,MVD)在大肠肿瘤中的表达,探讨其与大肠肿瘤癌变的关系及作为早期癌变生物学标志物的可能性。方法 采用免疫组化技术分别测定正常大肠黏膜、大肠息肉及大肠癌组织标本中Ki67、P53及MVD值,共80例,分析其变化规律及相关性。结果 在正常黏膜、大肠息肉、大肠癌组中的Ki67标记指数逐渐增高(分别为11.00±10.70、39.64±17.70、52.96±26.40),组间比较差异显著(P=0.0001)。正常黏膜组P53蛋白均为阴性,大肠癌组P53蛋白表达的阳性率明显高于息肉组(P=0.0001)。Ki67、P53蛋白表达与性别、年龄、病程、病变部位、大小、大肠癌的病理类型、Dukes分期均无相关性。正常黏膜、大肠息肉、大肠癌组的MVD值(14.80±5.10、19.70±7.84、36.56±20.40)逐渐上升,3组差别显著(P=0.0001)。大肠癌中Dukes C、D期的MVD值(40.56±3.49)明显高于A、B期(29.50±2.45)(P=0.016)。Ki67与P53在各种组织中的表达呈正相关(r=0.5149,P=0.015)。联合检测Ki67及P53鉴别大肠良恶性病变的敏感度(70.37％)低于单侧Ki67(96.30％),但特异度(94.34％)明显增高。结论 Ki67标记指数可反映细胞增殖状态,指数高的大肠腺瘤易发生癌变。MVD值高的大肠癌易发生转移,MVD可作为判断大肠癌预后的参考指?

Purpose: To observe the expression of Ki67, P53, microvessel density(MVD) in human colorectal tumor, to discuss the correlation between the three makers and carcinomatous change of colorectal tumor, and to determinate if they are the early carcinomatous change biological markers. Methods: The expression of Ki67, P53 proteins and microvessel density were detected by immunohistochemical methods of 80 specimens of normal colorectal mucosa, colorectal polyp and colorectal carcinoma. We analyzed the change law and the correlation. Results: The Ki67 marked index increased step by step in the three groups(11.00 ± 10.70, 39.64 ± 17.70, 52.96 ± 26.40, respectively), there was significantly difference between the three groups(P = 0. 000 1). P53 protein expression of normal group was negative, but is was significant higher in carcinoma group than polyp group (P = 0.000 1). Ki67, P53 protein expression was not correlated with gender, age, disease course, lesions position, size, pathological type, Dukes stages. MVD value of normal mucosa group, polyp group and carcinoma group increased gradually(14.80 ± 5.10, 19.70 ± 7.84, 36.56 ± 20.40, respectively), the difference was marked(P = 0.000 1). MVD value of colorectal carcinoma of Dukes C, D grades(40.56 ± 3.49) was significant higher than that of Dukes A, B grades(29.50 ± 2.45)(P = 0.016). A positive expression was present between Ki67 and P53 in different tissue(r = 0.514 9, P = 0.015). Detecting of Ki67 combining with P53 to differentiate benign or malignant colorectal lesions had lower sensitivity (70.37%) than detecting Ki67 alone(96.30%), but had significant higher specificity(94.34%). Conclusions: Ki67 marked index can express cell proliferation. Higher of the index, easier carcinomatous change of colorectal adenoma. The colorectal tumor with high MVD value can induce metastasis easily, it can be a prognosis reference index. There is strong correlation between Ki67 and P53. Detecting of Ki67 combining with P53 to differentiate benign or malignant colorectal lesions, filtrate high risk people has higher value than detecting Ki67 alone.