p16抑癌基因在胆管细胞性肝癌中的表达与预后的关系

目的研究ｐ１６抑癌基因与胆管细胞性肝癌发生、发展及预后的关系。方法用免疫组织化学染色ＳＰ法检测胆管细胞性肝癌３８例、癌旁胆管异型增生组织２６例及正常肝内胆管组织中ｐ１６抑癌基因１６例的表达情况。结果ｐ１６抑癌基因在胆管细胞性肝癌组织中表达率为２６％，明显低于癌旁胆管异型增生组织（６９％，Ｐ＜００１）及正常肝内胆管组织（８１％，Ｐ＜００１）；中、低分化胆管细胞性肝癌ｐ１６抑癌基因表达率（１５％）显著低于高分化胆管细胞性肝癌的ｐ１６抑癌基因表达率（５４％，Ｐ＜００５）；在伴有淋巴结转移和门静脉癌栓的病例中，ｐ１６抑癌基因表达率明显低于相应的对照组（Ｐ＜００５）；ｐ１６抑癌基因阳性病人５年生存率为５６％，而ｐ１６抑癌基因阴性病人５年生存率仅为１４％，二者相比差异有显著意义（Ｐ＜００５）；ｐ１６抑癌基因的表达与癌灶体积、癌灶数目及ＨＢｓＡｇ无关。结论ｐ１６抑癌基因的失表达可能在胆管细胞性肝癌的发生发展中起重要作用；ｐ１６抑癌基因表达与胆管细胞性肝癌的分化程度及有无淋巴结转移和门静脉癌栓形成有关，是判定胆管细胞性肝癌恶性程度及估计预后的重要指标之一。

Tumor suppressor gene p16 expression in cholangiocarcinoma and its relationship to prognosis

Objective To observe the relationship between tumor suppressor gene p16 expression and the occurrence,development and prognosis of cholangiocarcinoma.Methods Using SP immunohistochemistry method, we investigated the expression of p16 in paraffin embedded cholangiocarcinoma tissues in 38 cases.Results The positive rates of p16 in tissue of cholangiocarcinoma,the paracancerous bile duct epithelium with dysplasia and normal hepatic bile duct tissue were 26%,69% and 81%, respectively ( P <0 01);p16 was detected in moderately and poorly differentiated cholangiocarcinoma at the rate of 15%,and of 54% in well differentiated cholangiocarcinoma ( P <0 05). The expression of p16 in the cholangiocarcinomas with lymph node metastasis and portal vein cancerous thrombi was markedly lower than that in the cholangiocarcinomas without metastasis and invasion ( P <0 05).Patients with positive p16 expression had a much higher 5 year survival rate (56%) than those (14%) with negative expression,and no correlation was found between p16 expression and the size, and number of the tumours foci and the status of HBsAg.Conclusions The results suggest that p16 is closely related to the occurrence and development of cholangiocarcinoma, the expression of p16 is associated with the differentiation,metastasis and invasion, the state of p16 can be regarded as a marker for the prognosis of cholangiocarcinoma.