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目的 研究胆囊腺瘤从增殖到恶变中腺上皮细胞的增殖变化和基因表达。方法 用PCR-RFLP法测定APC、ras基因的表达,ABC免疫化学组织染色法测定p53基因蛋白的表达。用TJTY-300全自动图像分析仪测定胆囊上皮细胞核异型性和DNA含量。结果 (1)胆囊上皮细胞核异型性和DNA含量在胆囊腺瘤-腺癌过程中逐渐增加(P<0.05)。(2)胆囊腺瘤中异倍体比例与腺瘤的大小有明显的关系,直径≥1 cm异倍体比例显著增加(P<0.05)。(3)APC基因和ras基因参与胆囊腺瘤-腺癌过程。p53基因在这一过程中不表达。结论 胆囊腺瘤-腺癌的过程也是胆囊癌发生中一条重要的途径。当胆囊腺瘤直径≥1 cm时具有明显的癌变潜能。其基因表达与胆囊上皮不典型增生一原位癌途径不同,APC、ras基因在表达胆囊腺瘤-腺癌的途径中起主要作用。
Objective To study the proliferation and gene expression of proliferative and malignant glandular epithelial cells in gallbladder adenoma. Methods The expression of APC and ras genes was determined by PCR-RFLP and the expression of p53 gene protein was detected by ABC immunohistochemical staining. The gallbladder epithelial cell nuclear atypia and DNA content were determined by TJTY-300 automatic image analyzer. Results (1) The nuclear atypia and DNA content of gallbladder epithelial cells increased gradually during gallbladder adenoma-adenocarcinoma (P <0.05). (2) The proportion of aneuploidy in gallbladder adenoma was significantly related to the size of adenoma, and the proportion of aneuploidy with diameter≥1 cm was significantly increased (P <0.05). (3) APC gene and ras gene involved in gallbladder adenoma-adenocarcinoma process. The p53 gene is not expressed in this process. Conclusion The process of gallbladder adenoma - adenocarcinoma is also an important path in gallbladder carcinogenesis. When the gallbladder adenoma diameter ≥ 1 cm has obvious cancer potential. Its gene expression and gallbladder epithelial dysplasia - a carcinoma in situ pathways, APC, ras gene in the expression of gallbladder adenoma - adenocarcinoma pathway plays a major role.