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目的 观察正常大脑组织和星形细胞瘤组织 (Ⅰ～Ⅳ )中Ki 67、VEGF、bcl 2 ,cyclin D1与p1 6的表达 ,探讨其辅助诊断的意义。方法 应用免疫组化检测 1 3例正常脑组织和 58例星形细胞瘤组织中Ki 67,VEGF ,bcl 2 ,cy clin D1和p1 6的表达。结果经 χ2 检验和单因素方差分析。结果 Ki 67和VEGF在正常大脑组织中均不表达 ,而在所有级别的星形细胞瘤中均表达 ,差异极显著 (P <0 0 1 )。随着星形细胞瘤恶性程度的增高 ,Ki 67的表达增强 ,VEGF表达阳性的病例增加 ;肿瘤组织中微血管的形态亦出现相应的变化 ,每两组间的差异极显著 (P <0 0 1 )。bcl 2在 4个实验组中均表达 ,各组间表达差异显著 (P <0 0 1 ) ,且随着肿瘤恶性程度的增高表达增强。cyclin D1的表达阳性率各组间差异不显著 (P >0 0 5)。正常脑组织中p1 6有一定的表达 ,阳性率 69 2 % ;在转化为肿瘤细胞后p1 6的阳性率反而升高。肿瘤组织中 ,总的趋势是随着肿瘤恶性程度的增高p1 6的表达降低。结论 临床病理诊断过程中 ,Ki 67,bcl 2的免疫组化检测可对星形细胞瘤的分级诊断提供非常有意义的依据。而VEGF的作用需结合微血管形态的变化一起考虑。cyclin D1和p1 6的免疫组化检测不够敏感 ,故辅助诊断意义不大。
Objective To observe the expression of Ki 67, VEGF, bcl 2 and cyclin D1 and p16 in normal brain tissue and astrocytomas (I-IV), and to explore the significance of its auxiliary diagnosis. Methods Immunohistochemistry was used to detect the expression of Ki 67, VEGF, bcl 2, cy clin D1 and p16 in 13 normal brain tissues and 58 astrocytomas. The results were analyzed by χ2 test and one-way ANOVA. Results Ki 67 and VEGF were not expressed in normal brain tissues, but were expressed in all grades of astrocytomas. The difference was extremely significant (P < 0 01). With the increase of malignancy of astrocytoma, the expression of Ki 67 was increased and the number of cases with positive VEGF expression was increased. The morphology of microvessels in tumor tissues also showed corresponding changes. The difference between the two groups was extremely significant (P < 0 0 1 ). Bcl 2 was expressed in all four experimental groups, and there was a significant difference between the two groups (P < 0 01). The expression of bcl 2 increased with the increase of tumor malignancy. The positive rate of cyclin D1 expression was not significantly different among groups (P > 0.05). The expression of p16 in normal brain tissue was positive and the positive rate was 692%. The positive rate of p16 increased after transformed into tumor cells. In tumor tissues, the general trend is that the expression of p16 decreases as the degree of malignancy increases. Conclusion During clinical pathological diagnosis, immunohistochemical detection of Ki 67 and bcl 2 may provide a very useful basis for the diagnosis of astrocytoma. The role of VEGF needs to be considered in conjunction with changes in microvascular morphology. The immunohistochemical detection of cyclin D1 and p16 is not sensitive enough, so the auxiliary diagnosis is of little significance.