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目的 研究 p53、Bcl 2和Bax蛋白在胃癌组织中的表达及相互关系。方法 p53应用免疫组织化学SP法 ;Bcl 2 ,Bax应用SABC法。结果 p53、Bcl 2、Bax在胃癌中的表达分别为 4 9 3%、37 3%和57 3%。在正常胃粘膜表达分别为 0 (P <0 0 1)、16 7% (P >0 0 5)和 91 7% (P <0 0 5)。p53蛋白的表达与肿瘤的浸润深度、淋巴结转移、临床分期、远处转移有关。Bcl 2蛋白表达在低分腺癌的表达率 51 5% ,显著高于高中分化腺癌 ( 2 6 2 % ,P <0 0 5)。Bax在高中分化腺癌表达率 ( 69% ) ,显著高于低分化腺癌 ( 4 2 4 % ,P <0 0 5)。Bcl 2、Bax和其它临床病理参数无关。应用Spearman等级相关分析未发现突变 p53蛋白和Bcl 2及Bax蛋白表达有相关性。结论 ①p53基因突变可能主要作用于胃癌的进展期阶段 ,参与胃癌的浸润转移 ,p53有可能成为胃癌预后参数之一。②Bcl 2、Bax表达异常提示凋亡调控机制的异常在胃癌发病中可能起重要作用。Bcl 2、Bax可能参与胃癌的发生并和胃癌分化有关 ,但可能与预后无关。③ p53基因突变可能因失去对Bcl 2、Bax的调节作用 ,致Bcl 2过表达 ,Bax表达减弱。
Objective To investigate the expression and relationship of p53, Bcl 2 and Bax proteins in gastric cancer. Methods p53 was applied immunohistochemical SP method; Bcl 2 and Bax were applied SABC method. Results The expression of p53, Bcl 2 and Bax in gastric cancer were 493%, 37 3% and 57 3%, respectively. In the normal gastric mucosa, the expression was 0 (P <0 01), 16 7% (P> 0 05) and 91 7% (P <0 05). The expression of p53 protein is related to the depth of tumor invasion, lymph node metastasis, clinical stage, distant metastasis. The expression rate of Bcl-2 protein in low-grade adenocarcinoma was 51.5%, which was significantly higher than that of high-grade differentiated adenocarcinoma (26.2%, P < 0.05). The expression rate of Bax in high-grade differentiated adenocarcinoma (69%) was significantly higher than that of poorly-differentiated adenocarcinoma (424%, P < 0.05). Bcl 2, Bax and other clinicopathological parameters have nothing to do. Spearman rank correlation analysis showed no correlation between mutant p53 protein and Bcl 2 and Bax protein expression. Conclusion 1 p53 gene mutation may play a major role in the advanced stage of gastric cancer and participate in the invasion and metastasis of gastric cancer. p53 may become one of the prognostic parameters of gastric cancer. 2 The abnormal expression of Bcl 2 and Bax suggests that abnormal apoptosis control mechanisms may play an important role in the pathogenesis of gastric cancer. Bcl 2 and Bax may be involved in the occurrence of gastric cancer and related to the differentiation of gastric cancer, but may not be related to the prognosis. 3 p53 gene mutation may be due to loss of regulation of Bcl 2 and Bax, resulting in overexpression of Bcl 2 and decreased expression of Bax.