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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PCR-RFLP法测定APC、ras基因突变,ABC免疫化学组织染色法测定p53蛋白表达。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 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。胆囊腺瘤中异倍体比例与腺瘤的大小有明显的关系,直径≥1cm异倍体显著增加(P<0.05)。在胆囊腺瘤-腺癌过程中可检测到APC基因和RAS基因突变。P53蛋白在这一过程中不表达。结论 胆囊腺瘤-腺癌的过程是胆囊癌发生中一条重要的途径。当胆囊腺瘤直径≥1cm时具有明显的癌变潜能。其分子改变机制与胆囊上皮不典型增生-原位癌途径不同。
Objective To study the proliferation and gene expression of proliferative and malignant glandular epithelial cells in gallbladder adenoma. Methods The mutations of APC and ras gene were determined by PCR-RFLP and the expression of p53 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 Epithelial nucleus atypia and DNA content in gallbladder adenoma - adenocarcinoma process gradually increased. The proportion of aneuploidy in gallbladder adenoma was significantly related to the size of adenoma. The aneuploidy with diameter ≥1cm increased significantly (P <0.05). In gallbladder adenoma - adenocarcinoma APC gene and RAS gene mutations can be detected. P53 protein is not expressed in this process. Conclusion The process of gallbladder adenoma - adenocarcinoma is an important pathway in gallbladder carcinogenesis. When the gallbladder adenoma diameter ≥ 1cm when the obvious cancer potential. Its molecular change mechanism and gallbladder epithelial dysplasia - in situ carcinoma pathway different.