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目的 对正常结肠粘膜上皮 ,结肠上皮增生样息肉 ,结肠上皮腺瘤和结肠腺癌组织中P53 蛋白的表达进行了检测 ,并对其临床意义进行评估。方法 应用单克隆抗体DO - 7,采用免疫组织化学LSAB方法 ,对 7例结肠增生性息肉、5 9例结肠腺瘤 ( 2 6例管状腺瘤、13例混合状腺瘤、2 0例绒毛腺瘤 )和 30例结肠腺癌组织中P53 蛋白进行标记。结果 正常结肠上皮及增生性息肉组织中P53 蛋白标记阴性。结肠腺瘤和结肠腺癌组织中P53 表达阳性率明显增多差异有显著意义 (P <0 0 1)。结肠癌中P53 阳性率达 5 6 6 7% ,并与结肠癌的分化程度及临床Dukes分期有关 ,分化程度越高 ,P53 表达率越低。DukesA期结肠癌P53 表达率明显低于DukesD期 (P <0 0 5 )。结肠癌存活率随着P53 阳性率和阳性标记范围的增加而降低。标记范围大于 6 0 %者存活率明显低于标记范围小于 2 5 %者 (P <0 0 5 )。这也符合临床中DukesD期患者 5a存活率明显低于DukesA期患者的现象。在结肠腺瘤中 ,P53 阳性率与腺瘤的大小和是否伴有异型增生有关 ,腺瘤直径≥ 2 0mm者阳性率明显高于直径 <10mm者 (P <0 0 5 )。P53 蛋白表达随异型增生程度的增加而增加 ,重度异型增生和息肉癌变组织中P53 阳性率明显高于轻度异型增生腺瘤 ( P <0 0 5 ,P <0 0 5 )。在
Objective To detect the expression of P53 protein in normal colon mucosal epithelium, colon epithelial hyperplasia polyposis, colon epithelial adenoma and colon adenocarcinoma, and evaluate its clinical significance. METHODS: Monoclonal antibody DO-7 was used in the immunohistochemistry LSAB method for 7 cases of colon hyperplastic polyps and 59 cases of colon adenomas (26 cases of tubular adenomas, 13 cases of mixed adenomas, 20 cases of villous glands) Tumors) and P53 protein were labeled in 30 colon adenocarcinoma tissues. Results P53 protein was negative in normal colon epithelium and hyperplastic polyp tissue. The positive rate of P53 expression in colon adenoma and colon adenocarcinoma was significantly different (P < 0.01). The positive rate of P53 in colon cancer was 566.7%, which was related to the degree of differentiation of colon cancer and clinical Dukes stage. The higher the degree of differentiation, the lower the expression rate of P53. The expression of P53 in DukesA colon cancer was significantly lower than that in Dukes D (P <0 05). The survival rate of colon cancer decreased with the increase of the positive rate of P53 and the range of positive markers. The survival rate of the marker range greater than 60% was significantly lower than the marker range of less than 25% (P < 0.05). This is also consistent with the fact that the 5a survival rate in patients with Dukes D is significantly lower than that in Dukes A patients. In colonic adenomas, the positive rate of P53 was related to the size of adenomas and whether they were associated with dysplasia. The positive rate of adenomas ≥ 20 mm was significantly higher than those with diameters <10 mm (P < 0.05). The expression of P53 protein increased with the degree of dysplasia, and the positive rate of P53 in severe dysplasia and polyposis was significantly higher than that in mild dysplasia (P < 0.05, P <0 05). in