胆囊癌DNA含量、ER、PR、P53、P21表达与预后的意义

目的 探讨DNA含量，ER、PR和P53、P21在胆囊癌中的生物学意义及与预后的关系。方法 用HPIAS—1000DAN图像分析仪及即用型—抗 Envision微波加热免疫组化法，对18例胆囊癌行DNA检测，ER、PR和P53、P21表达分析，并随访。结果 胆囊高分化癌DNA含量为高二倍体，U值平均1．23；中分化癌为高二倍体至亚四倍体，U值平均1．55；低分化癌为四倍体，U值平均2．15。胆囊癌ER、PR阳性率为88．89％和72．22％；P53、P21阳性率均为66．67％。癌细胞分化越差，浸润越深，DNA多倍体及U值越高，ER、PR、P53、P21阳性率越高，预后越差。结论 DNA倍性改变及ER、PR和P53、P21阳性表达与胆囊癌的分化程度和浸润深度有关，对预后判断有重要意义。ER、PR过度表达可能诱发P53、P21基因突变，两在胆囊癌发生发展中有密切的内在联系。

Prognosis significance of DNA content and expression of ER、PR、P53、P21 in gallbladder carcinoma

Objective To investigate biological significance and inside relationship of DNA content and ER,PR,P53,P21 gene protein's occurrence and development in gallbladder carcinoma.Methods Adopt HIAS-100 DNA image instrument and Envision microwave-immunohistochemistry to DNA content examination and indicate expression analysis ER?PR&P53?P21 in 18 cases of gallbladder carcinoma.And cases were followed up.Results The high two-ploidy and U.average was 1 23 of DNA in higher split of gallbladder carcinoma;the polyploidy and U.average was 2 5 of DNA in low differentiate of gallbladder carcinoma.Positive expression rate of the ER was 88 89%?PR was 72 22% and P53?P21 all were 66 67% in gallbladder carcinoma.The poorer cancer cells differentiate and the deeper they infiltrate and the obvious polyploidy with higher U.average of DNA and higher positive expression rate are ER?PR&P53?P21 of gallbladder carcinoma and the poorer prognosis too.Conclusion the DNA changeful ploidesis and positive expression ER?PR&P53?P21 is related to the level of split extent and depth infiltrate of gallbladder carcinoma,it has greatly significant in the prognosis judgement.Excessive expression of ER?PR will possibly induce the matant of P53?P21 gene.They have closely inside relationship in the occurrence and development of gallbladder carcinoma.