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目的探讨P73、P53、P21waf1及PCNA在胃黏膜不同病变中的蛋白表达与胃黏膜上皮细胞癌变的关系、以及与胃癌临床病理特征之间的关系。方法应用免疫组织化学方法(S—P法)检测39例胃癌及17例萎缩性胃炎、40例慢性炎性息肉中的P73、P53、P21waf1和PCNA的表达情况,并结合临床病理资料进行统计学分析。结果胃癌中P73蛋白高表达,阳性率为64·1%(25/39),与慢性炎性息肉组、萎缩性胃炎组相比较有显著性差异(P<0.05);P73和P53、PCNA的表达呈正相关(P<0.05),和P21waf1呈负相关,P3的蛋白表达与组织学分型、黏膜浸润的深度、TNM分期、淋巴结转移无相关(P>0·05);胃癌中P53蛋白的阳性表达率为64.1%(25/39),与慢性炎性息肉组、萎缩性胃炎组相比较有显著性差异(P<0.05),P53的蛋白表达与胃癌的组织学分型、黏膜浸润的深度、TNM分期、淋巴结转移无相关(P>0.05);胃癌中P21waf1蛋白低表达,其阳性率为20.5%(8/39),胃癌组与慢性炎性息肉组、萎缩性胃炎组与慢性炎性息肉组相比较有显著性差异(P<0.05),P21waf1的蛋白表达与TNM分期及淋巴结转移呈负相关(P<0.05),与组织学分型、黏膜浸润的深度无相关(P>0.05);PCNA蛋白在胃癌中的阳性表达率为79.5%(31/39),与慢性炎性息肉组相比较有显著性差异(P<0.05),PCNA的蛋白表达与组织学分型、黏膜浸润的深度、TNM分期、淋巴结转移无相关(P>0.05)。结论P73高表达可能是一个胃癌发生的热点基因变化,在胃癌中P73蛋白的表达对胃癌的发生发展可能起着重要作用;P73作为抑癌基因有其组织特异性。P73和PCNA蛋白的协同表达,与P53、P21waf1的表达有一定的相关性,提示在胃癌的恶性转化、临床病理过程及判断预后方面有一定的临床意义。P21waf1可能是胃癌发生的一个早期信号,也可能是一个判断预后的指标之一。
Objective To investigate the relationship between the protein expression of P73, P53, P21waf1 and PCNA in gastric mucosal lesions and the carcinogenesis of gastric mucosal epithelial cells and the clinicopathological characteristics of gastric cancer. Methods The expressions of P73, P53, P21waf1 and PCNA in 39 cases of gastric cancer and 17 cases of atrophic gastritis and 40 cases of chronic inflammatory polyps were detected by immunohistochemical method (S-P method), and the clinical and pathological data were used for statistics analysis. Results P73 protein was highly expressed in gastric cancer with a positive rate of 64.1% (25/39), which was significantly different from those in chronic inflammatory polyp group and atrophic gastritis group (P <0.05). P73 and P53, PCNA (P0.05), but negatively correlated with P21waf1. There was no correlation between the expression of P3 protein and the histological type, the depth of mucosal invasion, TNM stage and lymph node metastasis (P> 0.05) .The positive expression of P53 protein in gastric cancer The expression of P53 was significantly higher than that in chronic inflammatory polyp group and atrophic gastritis group (P <0.05). The protein expression of P53 was correlated with histological type, depth of mucosal invasion, TNM staging and lymph node metastasis (P> 0.05). The positive rate of P21waf1 protein in gastric cancer was 20.5% (8/39). There was no significant difference between gastric cancer group and chronic inflammatory polyp group, atrophic gastritis group and chronic inflammatory polyp (P <0.05). The protein expression of P21waf1 was negatively correlated with TNM stage and lymph node metastasis (P <0.05), but not with the histological type and depth of mucosal invasion (P> 0.05). PCNA The positive expression rate of protein in gastric cancer was 79.5% (31/39), which was significantly different from that in chronic inflammatory polyp group (P <0.05) White expression and histological type, depth of mucosal invasion, TNM stage, lymph node metastasis was not related (P> 0.05). Conclusion The high expression of P73 may be a hot gene in gastric cancer. The expression of P73 protein in gastric cancer may play an important role in the development of gastric cancer. P73 as a tumor suppressor gene has its tissue specificity. The synergistic expression of P73 and PCNA protein has some correlation with the expression of P53 and P21waf1, suggesting that it has some clinical significance in the malignant transformation, clinicopathological process and prognosis of gastric cancer. P21waf1 may be an early sign of gastric cancer, may also be one of the indicators to determine the prognosis.