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目的阐明胃癌p53肿瘤抑制基因表达的临床病理意义。方法应用微波处理ABC免疫组化法,对88例胃癌进行了p53蛋白表达的检测。结果发现p53蛋白表达总的阳性率为36.4%,早期胃癌和进展期胃癌的阳性率分别为15%和42.6%,二者之间的差异有显著性(P<0.05)。癌旁组织(正常粘膜、肠上皮化生及异型增生)皆为阴性。p53阳性与组织类型及淋巴结转移无明显关系,而在增生活跃的或间变明显的肿瘤细胞区域可见p53蛋白异常表达,应用DH7标记肿瘤的增殖活性,p53阳性组(92.6%)非常明显地高于p53阴性组(63.2%)(P<0.01)。本组2年死亡率中,p53阳性表达肿瘤患者(69.0%)与非p53表达者(40.6%)相比较有显著性差异(P<0.05)。结论p53过表达的肿瘤具有高的增殖活性,而可作为胃癌患者缩短生存期的独立指标;p53的表达异常还是恶变之一标志。
Objective To elucidate the clinicopathological significance of p53 tumor suppressor gene expression in gastric cancer. Methods Microwave-assisted ABC immunohistochemistry was used to detect the expression of p53 protein in 88 cases of gastric cancer. The results showed that the total positive rate of p53 protein expression was 36.4%. The positive rates of early gastric cancer and advanced gastric cancer were 15% and 42.6%, respectively, and the difference between the two was significant (P<0.05). . Paraneoplastic tissues (normal mucosa, intestinal metaplasia, and dysplasia) were negative. There was no significant relationship between p53 positive and histological type and lymph node metastasis. However, abnormal expression of p53 protein was found in hyperplastic or interstitial tumor cell areas. The proliferative activity of tumors was marked by DH7, and the p53 positive group (92.6%) was very obvious. It was higher than the p53 negative group (63.2%) (P<0.01). In this 2-year mortality rate, there was a significant difference (p<0.05) between p53-positive tumor patients (69.0%) and non-p53-expression tumors (40.6%). Conclusion p53 over-expressed tumors have high proliferative activity and can be used as an independent marker to shorten the survival of patients with gastric cancer. The abnormal expression of p53 is also a sign of malignant transformation.