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目的 :探讨表浅性膀胱移行细胞癌中Bcl 2和 p5 3的同时表达与膀胱癌预后之间的关系。 方法 :应用免疫组化技术 (SABC法 )检测 4 2例表浅性膀胱癌蜡块标本中Bcl 2和p5 3的表达。患者术后平均随访 36个月 ,14例复发 ,其中复发 2次以上 9例 ,有转移者 4例。结果 :4 2例中 ,31例 (73.8% ) p5 3阳性表达 ,与G1(6 2 .5 % )和G2 (72 .2 % )相比较 ,G3 (81.2 % )更多见 ;pT1期 (78.6 % )p5 3阳性率较 pTa期 (6 4 .3% )高。 12例(2 8.6 % )发现有Bcl 2表达 ,Bcl 2表达阳性率G3 (37.5 % )明显高于G2 (2 2 .2 % )和G1(2 5 .0 % ) ,与分期无关 (P>0 .0 5 )。膀胱癌复发率p5 3基因表达阳性者高于阴性者 (P <0 .0 5 ) ,而Bcl 2基因表达阳性者与阴性者的差别无统计学意义 (P >0 .0 5 ) ,但 p5 3和Bcl 2同时呈阳性表达者 (8例 )明显高于其他患者 (P <0 .0 1)。Bcl 2和p5 3的阳性表达与肿瘤侵袭性和淋巴结及远处转移有关。结论 :p5 3和Bcl 2同时阳性表达的肿瘤患者预后较差 ,两者同时检测对判断膀胱癌复发及预后更具有指导意义。
Objective: To investigate the relationship between the expression of Bcl-2 and p53 in superficial bladder transitional cell carcinoma and the prognosis of bladder cancer. Methods: The expression of Bcl-2 and p5 3 in paraffin-embedded specimens of 42 cases of superficial bladder cancer was detected by immunohistochemistry (SABC method). Patients were followed up for an average of 36 months postoperatively, and 14 patients relapsed. Of them, 9 patients had recurrence more than 2 times and 4 patients had metastasis. Results: The positive expression of p5 3 in 31 cases (73.8%) was higher than that in G1 (72.5%) and G2 (72.2%) 78.6%) p5 3 positive rate than the pTa period (64.3%). Bcl-2 expression was found in 12 cases (28.6%), the positive rate of Bcl-2 expression was significantly higher than that in G2 (22.2%) and G1 (25.0%), 0 .0 5). The positive rate of bladder cancer recurrence rate p5 3 was higher than that of negative (P <0.05), while there was no significant difference between Bcl 2 positive and negative (P> 0.05), but p5 3 and Bcl 2 positive at the same time (8 cases) were significantly higher than other patients (P <0.01). The positive expression of Bcl 2 and p5 3 is related to tumor invasion and lymph node metastasis. Conclusions: The prognosis of tumor patients with both p5 3 and Bcl 2 positive expression is poor. The simultaneous detection of these two markers is more instructive in judging the recurrence and prognosis of bladder cancer.