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目的 :探讨p16、Ki-67和PCNA的表达与胃肠道平滑肌肿瘤 (gastrointestinalsmoothmuscletumors,GISMT)性质的关系。方法 :采用免疫组织化学S -P法检测86例GISMT患者p16的表达情况,采用微波修复抗原及免疫组织化学S -P法检测人抗增殖细胞核抗原Ki-67及增殖细胞核抗原(proliferatingcellnuclearantigen,PCNA)来反映细胞的增殖活性。结果 :p16表达按平滑肌瘤、平滑肌肉瘤Ⅰ、Ⅱ、Ⅲ级的顺序依次明显下降 (P<0.01)。同时 ,p16的表达与肿瘤的良恶性生长方式、肿瘤大小、中心有无坏死亦有明显的关系 (P<0.01或P<0.05)。p16阳性表达组5年生存率明显高于阴性表达组 (P<0.05)。p16阴性表达组的Ki-67和PCNA表达明显高于阳性表达组(P<0.01)。结论 :p16可考虑是反映GISMT某些生物学特性的良好标志物 ,可以用来判断其某些生物学特性、估计预后、指导制定合理的治疗方案。p16与Ki-67、PCNA可以互补作为判断GISMT良恶性、恶性程度、转移及预后的参考指标。
Objective: To investigate the relationship between the expression of p16, Ki-67 and PCNA and the gastrointestinalsmooth muscle tumors (GISMT). Methods: The expression of p16 in 86 patients with GISMT was detected by immunohistochemical S-P method. The expressions of Ki-67 and PCNA in human anti-proliferating cell nuclear antigen (PCNA) were detected by using microwave repair antigen and immunohistochemical S-P method. To reflect the cell proliferative activity. Results: The expression of p16 was significantly decreased in the order of leiomyoma and leiomyosarcoma Ⅰ, Ⅱ and Ⅲ (P <0.01). At the same time, the expression of p16 was significantly correlated with the benign and malignant growth of tumors, tumor size, and the presence or absence of necrosis in the center (P <0.01 or P <0.05). The 5-year survival rate of p16 positive group was significantly higher than that of negative group (P <0.05). The expression of Ki-67 and PCNA in p16 negative group was significantly higher than that in positive group (P <0.01). Conclusion: p16 can be regarded as a good marker to reflect some biological characteristics of GISMT. It can be used to judge some biological characteristics, estimate prognosis and guide the development of rational treatment plan. p16 and Ki-67, PCNA can complement each other as a reference to determine the benign and malignant, malignant, metastasis and prognosis of GISMT.