结肠异时性腺瘤中Bcl—2和P^53异常表达的临床病理研究

目的　探讨结肠异时性腺瘤 Bcl- 2和 P53异常表达与病理分型的关系及其临床意义。方法　对 192例初发性息肉样病变应用免疫组化方法检测 Bcl- 2及 P53基因表达。结果　 Bcl- 2、P53阳性率在异时性腺瘤比初发性腺瘤明显增高 ,随着肿瘤病理分级增加阳性率上升 ,呈正相关性 (P<0 .0 1)。 Bcl- 2 / P53 组异时性腺瘤发病间期明显缩短 ,较阴性有显著性差异 (P<0 .0 1)。结论　 Bcl- 2 / P53 异时性腺瘤发病间期短 ,增殖活性强恶性潜能高。检测此项目可作为判断结肠腺瘤恶性潜能的重要生物学指标。

Clinicopathologic Study of Bcl-2 and P53 Expression in Metachronous Colorectal Adenomas

Objective To investigate the relati onship between histological grade of the colorectal metachronous adenoma and the expression of Bcl-2 and P 53 ,and its clinical significance.Method s Expression of Bcl-2 and P 53 of 105 cases of initial polyps and 87 colorectal metachronous adenomas were comparatively assessed by immunohistoch emistry.Results Bcl-2 and P 53 expression were closely cor related with histopathological grade of colorectal metachronous adenomas.Positiv e rates of Bcl-2 and P 53 expression in metach ronous adenomas were rather higher than the initial adenoma with degree of dysplasia,and the positive rates were more and more higher with cytological and structural atypia.Positive Bcl-2 and P 53 protein accumulation were significantly higher in the metachronous adenoma than in the initial coloractal adenomas(P<0.01).Compar ing follow-up of the each group of metachronous adenomas,a mean follow-up peri od of Bcl-2 /P 53 was shortest in four group (P<0.01) .Conclusions Colorectal metachronous adenoma of Bcl-2 /P 53 had a shorter follow-up period,higher proliferative activity and potent ial of being precursors of carcinoma,Bcl-2 expression and P 53 protein dete ction might be a useful biologic marker for malignant potential in colorectal me tachronous adenomas.