多原发膀胱癌中P53、PCNA、bcl-2、EGFR表达的研究

目的:研究P53、PCNA、bcl-2、EGFR在多原发膀胱癌与单发膀胱癌中的表达情况,探讨其意义及价值,为临床诊断、鉴别诊断及靶向治疗多原发膀胱癌提供依据。方法:运用免疫组化方法检测1996年～2011年间收治并经病理检查确诊的多原发膀胱癌标本15例、单发膀胱癌标本15例(临床分期、病理分级与多原发膀胱癌相同)、正常膀胱组织15例中P53、PCNA、bcl-2、EGFR的表达情况,比较其阳性表达率及程度的差异。结果:多原发膀胱癌及单发膀胱癌中P53、PCNA、bcl-2、EGFR阳性表达均高于正常膀胱组织(P<0.05),多原发膀胱癌中P53、bcl-2阳性表达高于单发膀胱癌(P<0.05),多原发膀胱癌中EGFR阳性表达低于单发膀胱癌(P<0.001),多原发膀胱癌中PCNA阳性表达与单发膀胱癌差异无统计学意义(P>0.05)。结论:多原发膀胱癌与单发膀胱癌中P53、bcl-2、EGFR表达有差异性(P<0.05),P53、bcl-2高表达而EGFR低表达见于多原发膀胱癌,联合检测P53、bcl-2、EGFR在诊断和鉴别诊断多原发膀胱癌中有一定临床价值。EGFR在多原发膀胱癌中的表达明显高于正常膀胱组织(P<0.001),这为靶向治疗多原发膀胱癌提供了可能。

Expression of P53 and PCNA and bcl-2 and EGFR in patients with multiple primary bladder cancers

Objective:To study the expression and clinical features of P53,PCNA,bcl-2 and EGFR in multiple primary bladder cancers and bladder cancers,and provide evidence for diagnosis and target treatment for multiple primary bladder cancers.Methods:Immunohistochemical SP methods were used to detect the expression of P53 and PCNA and bcl-2 and EGFR in 15 patients with multiple primary bladder cancers,15 patients with bladder cancers(The clinical stage and pathological grade of patients with bladder cancers were similar to those with multiple primary bladder cancers) and 15 patients with normal bladders,the differences from expressions of P53,PCNA,bcl-2 and EGFR in each group were analysed.All the patients have been treated during from 1996 to 2011 in our hospital and were confirmed by pathological examination.Results:The positive expression of P53 and PCNA and bcl-2 and EGFR in patients with multiple primary bladder cancers and bladder cancers were significantly higher than that in patients with normal bladders(P<0.05).The positive expression of P53 and bcl-2 in patients with multiple primary bladder cancers was higher than that in patients with bladder cancers(P<0.05),while the positive expression of EGFR in patients with multiple primary bladder cancers was significantly lower than that in patients with bladder cancers(P<0.001).The positive expression of PCNA between multiple primary bladder cancers tissues and bladder cancers tissues has not different(P>0.05).Conclusions:The positive expression of P53,bcl-2 and EGFR was different in multiple primary bladder cancers and bladder cancers.The highly positive expression of P53 and bcl-2 and the lowly positive expression of EGFR can occur simultaneously in multiple primary bladder cancers.The combined detection of P53,bcl-2 and EGFR is valuable for the clinical diagnosis and identification of multiple primary bladder cancers.The higher expression of EGFR in multiple primary bladder cancers than that in patients with normal bladders may provide the possibility of the targeting therapy of multiple primary bladder cancers.