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目的 探讨 β catenin、p5 3和增殖细胞核抗原 (PCNA)在大肠腺瘤癌变中的可能作用。方法 以免疫组织化学方法检测 77例大肠腺瘤 (CRA)及癌变组织中 β catenin、p5 3蛋白及PCNA的表达情况。结果 CRA随上皮不典型增生程度的提高以及癌变的出现 ,β catenin异常表达率逐渐增高(P <0 .0 1)。伴中、重度上皮不典型增生的CRA和CRA癌变组织中 ,β catenin核表达阳性率均明显高于上皮轻度不典型增生的CRA(P <0 .0 1)。CRA伴轻度不典型增生和CRA伴中、重度不典型增生及CRA癌变 3组的p5 3蛋白和PCNA表达依次增高 ,其阳性率分别为 10 .3%、43.8%、75 .0 %和 17.2 %、6 2 .5 %、87.5 %。在 β catenin核表达阳性者中 ,其PCNA的强阳性表达率明显高于 β catenin核表达阴性者 (6 9.7%和 36 .4% ,P <0 .0 5 ) ;在p5 3蛋白表达阳性者中 ,其PCNA的强阳性表达率明显高于p5 3表达阴性者 (72 .4%和 37.5 % ,P <0 .0 5 )。在CRA癌变组中 ,有 5 0 .0 %可见 β catenin和p5 3同时表达。结论 β catenin、p5 3和PCNA在CRA癌变过程中可能发挥了重要作用。
Objective To investigate the possible role of β catenin, p5 3 and proliferating cell nuclear antigen (PCNA) in the carcinogenesis of colorectal adenoma. Methods The expressions of β catenin, p5 3 protein and PCNA in 77 cases of colorectal adenoma (CRA) and cancerous tissues were detected by immunohistochemistry. Results The abnormal expression of β-catenin increased with the increase of atypical hyperplasia of CRA and carcinogenesis (P <0.01). The positive rate of β catenin in CRA and CRA carcinomas with moderate and severe atypical hyperplasia was significantly higher than that of mild atypical hyperplasia of epithelium (P <0.01). The positive rate of p5 3 protein and PCNA in CRA patients with mild atypical hyperplasia and moderate or severe CRA accompanied with severe atypical hyperplasia and CRA carcinomatosis were significantly higher than those in CRA patients (10.3%, 43.8%, 75.0% and 17.2% respectively) %, 62.5%, 87.5%. The strong positive expression rate of PCNA in β catenin nuclear positive group was significantly higher than that in β catenin nuclear negative group (6 9.7% and 36.4%, P <0.05). In the positive expression of p53 protein , The strong positive expression rate of PCNA was significantly higher than that of p5 3 negative expression (72.4% and 37.5%, P <0.05). In the CRA cancerous group, 50% showed that both β catenin and p5 3 expressed at the same time. Conclusion β catenin, p5 3 and PCNA may play an important role in the carcinogenesis of CRA.