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目的:分析P27蛋白在不同临床分型和病理分型的腺性膀胱炎中的表达,探讨不同分型腺性膀胱炎的恶变可能性,为临床治疗提供依据。方法:对85例腺性膀胱炎组织进行临床分型和病理分型,25例正常膀胱黏膜组织作为对照,应用免疫组织化学(免疫组化)S-P法检测不同类型的腺性膀胱炎组织和正常膀胱黏膜组织中P27蛋白的表达程度,并利用全自动显微镜及图像分析系统对免疫组化染色结果进行图像采集及统计分析。结果:不同临床分型的腺性膀胱炎组织中,乳头型和肠腺瘤型腺性膀胱炎的P27蛋白阳性表达均显著低于正常膀胱组织(P<0.01),而慢性炎症型和滤泡型腺性膀胱炎的P27蛋白阳性表达与正常膀胱组织差异无统计学意义(P>0.05);不同病理分型的腺性膀胱炎组织中,肠化生型和前列腺型腺性膀胱炎的P27蛋白阳性表达均低于正常膀胱黏膜组织(P<0.01),而移行上皮型腺性膀胱炎的P27蛋白阳性表达与正常膀胱组织差异无统计学意义(P>0.05)。结论:临床分型中,乳头型和肠腺瘤型腺性膀胱炎可能为癌前病变;病理分型中,肠化生型和前列腺型腺性膀胱炎可能为癌前病变。对于乳头型和肠腺瘤型腺性膀胱炎伴有肠化生或前列腺上皮化生者,癌变可能大,应积极手术治疗,术后抗肿瘤药物膀胱灌注,并密切随访。
OBJECTIVE: To analyze the expression of P27 in glandular cystitis with different clinical types and histopathological types, and to explore the possibility of malignant transformation of different types of glandular cystitis, so as to provide the basis for clinical treatment. Methods: Totally 85 cases of glandular cystitis were divided into two groups according to their clinical types and pathological types. Twenty-five normal bladder mucosa tissues were used as control. Immunohistochemistry (SP method) was used to detect the different types of glandular cystitis tissues and normal The expression of P27 protein in bladder mucosa was detected by immunohistochemical staining and statistical analysis with automatic microscope and image analysis system. Results: The positive expression of P27 protein in glandular cystitis of papillary and enteric adenoma was significantly lower than that of normal bladder tissue (P <0.01) in different clinical types of glandular cystitis, but the chronic inflammatory and follicular The positive expression of P27 protein in gonadal cystitis was not significantly different from that in normal bladder tissue (P> 0.05). P27 in different pathological types of glandular cystitis tissues, intestinal metaplasia and prostatic cystitis (P <0.01). The positive expression of P27 protein in transitional epithelial glandular cystitis was not significantly different from that in normal bladder tissues (P> 0.05). Conclusions: In clinical classification, glandular cystitis of papillary and enteric adenoma may be precancerous lesions. In pathological classification, intestinal metaplasia and prostatic glandular cystitis may be precancerous lesions. For papillary and enteric adenoid cystitis associated with intestinal metaplasia or prostate epithelial metaplasia, cancer may be large, should be actively surgical treatment, postoperative anti-tumor drug bladder perfusion, and close follow-up.