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目的 :为了估价在胃癌形态发展多阶段中 P5 3蛋白表达与癌伴神经内分泌分化的关系。方法 :用免疫组化 S-P法研究胃癌 10 0例、癌旁胃粘膜上皮病灶 12 2个 (包括单纯性增生 2 9例 ,轻中度异型增生 66例 ,重度异型增生 2 7例 )中 P5 3蛋白、嗜铬粒蛋白 A( Cg A)、囊泡突触素 ( SYN)的表达。结果 :癌旁病灶中 P5 3蛋白阳性率 3 .2 8%,癌中为 5 0 .0 0 %;Cg A和 SYN在癌旁病灶中为2 1.3 1%和 4.92 %,癌中为 3 6.0 0 %和 16.0 0 %。 P5 3蛋白、Cg A和 (或 ) SYN表达在癌中均明显高于癌旁病灶 ( P<0 .0 1)。随着癌分化降低 ,P5 3蛋白表达增强 ,但在 P5 3不同表达强度时 Cg A和 (或 ) SYN表达无显著差异。结论 :P5 3蛋白表达可出现于胃癌早期 ,但表达增强时为癌发生阶段的较晚期事件。伴有 Cg A和 (或 ) SYN阳性的神经内分泌细胞是癌的一种成份。P5 3蛋白、Cg A、SYN间并无相关性 ,是胃癌形态发生各阶段的独立指标 ,它们从不同角度反映了肿瘤发生、发展的情况。
OBJECTIVE: To evaluate the relationship between the expression of P53 protein and the neuroendocrine differentiation in the multiple stages of gastric cancer. Methods: Immunohistochemical SP method was used to study the expression of P53 in gastric cancer (P0.05), gastric cancer (122 cases), including 29 cases of simple hyperplasia, 66 cases of mild to moderate dysplasia and 27 cases of severe dysplasia Protein, Chromogranin A (CgA), Synaptophysin (SYN). Results: The positive rate of P53 protein in adjacent noncancerous lesions was 3.28%, and it was 50.0% in cancerous tissues. The positive rates of Cg A and SYN were 21.31% and 4.92% in cancerous adjacent tissues and 3 6.0 0% and 16.0 0%. The expression of P53 protein, Cg A and / or SYN was significantly higher in cancers than in paracancerous lesions (P <0.01). P5 3 protein expression increased with the decrease of cancer differentiation, but there was no significant difference in the expression of Cg A and / or SYN between different P5 3 expression levels. CONCLUSION: The expression of P53 protein may appear in the early stage of gastric cancer, but it may be the later event in the stage of carcinogenesis. Neuroendocrine cells with Cg A and / or SYN positive are a component of cancer. P5 3 protein, Cg A, SYN no correlation between the various stages of gastric cancer is an independent indicator of their reflection from different angles of tumor occurrence and development.