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目的 研究膀胱癌中抑癌基因 p16和 p5 3的表达及其与临床病理特征及预后的关系。 方法 应用免疫组织化学ABC法和微波炉抗原修复法对 6 9例膀胱移行细胞癌标本中抑癌基因p16和突变型p5 3蛋白产物进行检测。结果 6 9例膀胱癌标本中 37例p16检测阳性 (5 3.6 2 % ) ,30例 p5 3检测阳性 (43.48% )。p16阳性率在Ⅰ、Ⅱ和Ⅲ级肿瘤中分别为 6 9.5 7%、5 6 .2 5 %和 2 1.43% ,在Tis～T1期和T2 ～T4 期肿瘤中分别为 70 .5 9%和 37.14%。p5 3阳性率在Ⅰ、Ⅱ和Ⅲ级肿瘤中分别为 2 6 .0 9%、46 .88%和 6 4.2 9% ,在Tis～T1期和T2 ～T4 期肿瘤中分别为2 9.41%和 5 7.14%。随着膀胱癌病理分级、临床分期的上升 ,p16表达阳性率逐渐下降 ,p5 3阳性率逐渐上升。p16阴性或 p5 3阳性患者的肿瘤复发率和病死率分别高于p16阳性或 p5 3阴性患者。 结论 p16和p5 3的表达状况与膀胱癌生物学行为密切相关。p16和 p5 3的免疫组化检测具有评估膀胱癌预后的价值 ,可作为膀胱癌的生物学瘤标。
Objective To study the expression of tumor suppressor genes p16 and p5 3 in bladder cancer and their relationship with clinicopathological features and prognosis. Methods Immunohistochemical ABC method and microwave antigen retrieval method were used to detect the products of tumor suppressor gene p16 and mutant p5 3 in 69 specimens of bladder transitional cell carcinoma. Results The positive expression of p16 was detected in 37 out of 69 bladder cancer samples (53.6%) and 30 (43.48%) in p30 cases. The positive rates of p16 were 6 9.57%, 52.5% and 21.43% in grade I, grade II and grade III tumors respectively, and were 70.59% in Tis ~ T1 and T2 ~ T4 tumors respectively 37.14%. The positive rate of p53 was 26.09%, 46.88% and 62.29% in grade I, grade II and grade III tumors respectively, which were respectively 2. 9.41% in Tis ~ T1 and T2 ~ T4 tumors and 5 7.14%. With the pathological grade of bladder cancer and clinical stage, the positive rate of p16 gradually decreased and the positive rate of p5 3 gradually increased. The tumor recurrence rate and mortality of patients with p16 negative or p5 3 positive were higher than those of p16 positive or p5 3 negative respectively. Conclusion The expressions of p16 and p5 3 are closely related to the biological behavior of bladder cancer. Immunohistochemical detection of p16 and p5 3 has the value of assessing the prognosis of bladder cancer and can be used as a biological marker of bladder cancer.